Active NPI
Tracey Oberg
- Dental Hygienist
- New Haven, CT
National Provider Identifier
1285010504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 007830
- Practice address
- 54 Meadow St
3Rd Floor School Health Center
New Haven, CT 06519-1783 - Phone
- (203) 946-4860
- NPI assigned
- Aug 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 007830 | CT | Primary |
Addresses
Primary practice location
54 Meadow St
3Rd Floor School Health Center
New Haven, CT 06519-1783
Mailing address
31 Carpenter Ave
Meriden, CT 06450-6105
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007830 | CT | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Haven Public Schools | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- New Haven, CT
- NPI 1336518034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1285010504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 CARPENTER AVE",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064506105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 MEADOW ST",
"address_2": "3RD FLOOR SCHOOL HEALTH CENTER",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191783",
"telephone_number": "203-946-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBERG",
"first_name": "TRACEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CT",
"license": "007830",
"primary": true
}
],
"identifiers": [],
"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 Aug 10, 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.