Individual provider Active NPI

Robert Barry Rosenblitt, DDS

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1265570097
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8938 Issued in CT
Practice address
1574 Chapel Street
New Haven, CT 06511-4205
Phone
(203) 865-1480
Fax
(203) 865-0290
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 008938 CT
General Practice Dentistry 1223G0001X 8938 CT Primary

Addresses

Primary practice location

1574 Chapel Street
New Haven, CT 06511-4205

Mailing address

55 Salem Rd
Fairfield, CT 06824-7142
Phone (203) 260-7163

Other identifiers 1

IdentifierTypeStateIssuer
002089383MedicaidCA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8938CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1265570097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SALEM RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068247142",
            "telephone_number": "203-260-7163",
            "fax_number": "203-865-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 CHAPEL STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114205",
            "telephone_number": "203-865-1480",
            "fax_number": "203-865-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLITT",
        "first_name": "ROBERT",
        "middle_name": "BARRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "008938",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002089383",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.