Individual provider Active NPI

Joy Richardson

  • Pediatric Dentistry
  • Fairfield, CT
National Provider Identifier
1245669407
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12249 Issued in CT
Practice address
1478 Post Rd
Fairfield, CT 06824-5938
Phone
(203) 307-1550
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.024107 OH
Pediatric Dentistry 1223P0221X 12249 CT Primary

Addresses

Primary practice location

1478 Post Rd
Fairfield, CT 06824-5938

Mailing address

19 Day St Apt 312
Norwalk, CT 06854-4912
Phone (256) 679-6418

Other practice location 1

3353 Mahoning Ave
Youngstown, OH 44509-2617
Phone (330) 792-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190424002723 NY Order and Referring Only - DentistPractitioner - Dentist 5597007492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024107OHMDGeneral Practice Dentistry
12249CTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Big Smiles Pediatric Dentistry and Orthodontics, PC Current Accepting new patients
Mahoning Avenue Dental Health Center Michael Crites DDS Inc General Practice PastSince Apr 6, 2023 Accepting new patients
Youngstown Smiles Youth Dentistry Llcmichael Crites DDS General Practice Past Accepting new patients

Organizations & group practices 3

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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1245669407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAY ST APT 312",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068544912",
            "telephone_number": "256-679-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245938",
            "telephone_number": "203-307-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3353 Mahoning Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445092617",
            "country_code": "US",
            "telephone_number": "330-792-9600",
            "fax_number": "330-792-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024107",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "12249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.