Individual provider Active NPI

Dennis John Connaughton, DMD

  • Dentist
  • Cocoa, FL
National Provider Identifier
1245438019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8133 Issued in FL
Practice address
1519 Clearlake Rd
Cocoa, FL 32922-6598
Phone
(321) 433-7570
Fax
(321) 433-7711
NPI assigned
Jul 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8133 FL Primary

Addresses

Primary practice location

1519 Clearlake Rd
Cocoa, FL 32922-6598

Mailing address

2700 Dixie CT
Cocoa, FL 32922-7021
Phone (321) 433-7567

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

LicenseStateTypeSpecialty
8133FLMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245438019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DIXIE CT",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227021",
            "telephone_number": "321-433-7567",
            "fax_number": "321-433-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 CLEARLAKE RD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329226598",
            "telephone_number": "321-433-7570",
            "fax_number": "321-433-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNAUGHTON",
        "first_name": "DENNIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "8133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.