Rachel Maciog, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11581 Issued in CT

Practice address

825 Cromwell Ave Ste F
Rocky Hill, CT 06067-3013

Phone

(860) 726-7921

NPI assigned

Jun 18, 2015

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

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

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1306227012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-4529",
            "fax_number": "860-714-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CROMWELL AVE STE F",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673013",
            "telephone_number": "860-726-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIOG",
        "first_name": "RACHEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Lundell
• Lutheran Community Services, Inc.
• Luxottica of America Inc.
• Jody Biancamano Lynch, MSN, FNP-BC
• Karin M. Maandi
• Jessica Mahoney, OT
• Shelly A Malanson, LCSW
• Tarannum Malwat
• Blake Mamaclay, M.S., BCBA, LBA
• Maple View Manor of CT LLC

• General Practice Dentistry in Rocky Hill, CT
• Providers in Rocky Hill, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.