Aurora Degollado

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13384 Issued in CT

Practice address

710 King St
Bristol, CT 06010-4477

Phone

(860) 583-8469

NPI assigned

Jun 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ruth Aurora Zamora Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tiny Teeth Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Bristol, CT
  • NPI 1790492312
  NPD
• Tiny Teeth General Dentistry LLC

  • Pediatric Dentistry
  • Bristol, CT
  • NPI 1831415405

  General Practice

  NPD (past)

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1295021715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SALISBURY WAY",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321439",
            "telephone_number": "860-404-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KING ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104477",
            "telephone_number": "860-583-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGOLLADO",
        "first_name": "AURORA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "13384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUTH",
            "last_name": "ZAMORA",
            "middle_name": "AURORA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tashana Abigail Davis, RN
• David Dawiczyk
• Angelo De Los Angeles, M.D.
• Robert C Debiase, MD
• Taissa Decyk, PTA
• George Delcampo, PHARMD
• Misty Delciampo, PMHNP-BC
• Della Porta Eyecare, LLC
• Maria Pasqualina Della Porta, OD
• Marissa Rose Demers, PA-C

• All providers in Bristol, CT
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.