Individual provider Active NPI

Stanislav Gintautas, DDS

  • General Practice Dentistry
  • Stamford, CT
National Provider Identifier
1245557644
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010226 Issued in CT
Practice address
587 Elm St
Stamford, CT 06902-5113
Phone
(203) 359-6888
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 010226 CT Primary

Addresses

Primary practice location

587 Elm St
Stamford, CT 06902-5113

Mailing address

55 Elm St
Lynbrook, NY 11563-3629
Phone (646) 684-5717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108002370 CT Order and Referring Only - DentistPractitioner - Dentist 9436451325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010226CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Group of Stamford General Practice Past Accepting new patients
Family Dentistry of Bridgeport P.C. General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1245557644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 ELM ST",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633629",
            "telephone_number": "646-684-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 ELM ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025113",
            "telephone_number": "203-359-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINTAUTAS",
        "first_name": "STANISLAV",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.