Active NPI
Lisa Danielle McCoy
- General Practice Dentistry
- Glastonbury, CT
National Provider Identifier
1235468232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2-010176
- Practice address
- 3043A Main Street
Glastonbury, CT 06033 - Phone
- (860) 657-9212
- NPI assigned
- Dec 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2-010176 | CT | Primary |
Addresses
Primary practice location
3043A Main Street
Glastonbury, CT 06033
Mailing address
126 Hoyt St Apt 5B
Stamford, CT 06905-5765
Phone (734) 395-7546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2-010176 | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261440000000",
"number": "1235468232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 HOYT ST APT 5B",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069055765",
"telephone_number": "734-395-7546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3043A MAIN STREET",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "06033",
"telephone_number": "860-657-9212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "LISA",
"middle_name": "DANIELLE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-22",
"last_updated": "2009-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "2-010176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.