NPIMap

Organization Active NPI

Irving M Edelson DDS and David R Edelson DMD PC

Doing business as David R Edelson DMD PC

  • Dentist
  • Plainville, CT
National Provider Identifier
1275806481
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
006399 Issued in CT
Legal business name
IRVING M EDELSON DDS AND DAVID R EDELSON DMD PC
Doing business as
David R Edelson DMD PC
Practice address
92 East St
Plainville, CT 06062-2302
Phone
(860) 747-1004
Fax
(860) 793-2219
NPI assigned
Feb 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

Authorized official

Name
Dr. David Ross Edelson, DMDNPI 1487656377
Title
President
Phone
(860) 747-1004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 006399 CT Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

92 East St
Plainville, CT 06062-2302

Mailing address

92 East St
Plainville, CT 06062-2302
Phone (860) 747-1004

Other names 1

  • David R Edelson DMD PC Doing business as

National Provider Directory

National Provider Directory

Locations

92 East St
Plainville, CT 06062
Phone (860) 398-4966

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1275806481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622302",
            "telephone_number": "860-747-1004",
            "fax_number": "860-793-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622302",
            "telephone_number": "860-747-1004",
            "fax_number": "860-793-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVING M EDELSON DDS AND DAVID R EDELSON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-18",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "EDELSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-747-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "006399",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David R Edelson DMD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.