Individual provider Active NPI

David Phelps Jr., DDS

  • Dentist
  • Groton, CT
National Provider Identifier
1316929219
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2861 Issued in NV
Practice address
341 Grunnion Ave
Branch Dental Clinic
Groton, CT 06349-5050
Phone
(860) 694-2377
Fax
(860) 694-2590
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2861 NV Primary

Addresses

Primary practice location

341 Grunnion Ave
Branch Dental Clinic
Groton, CT 06349-5050

Mailing address

Route 12 BLDG 449
Attn Professional Affairs
Groton, CT 06349-5600
Phone (860) 694-2377

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

LicenseStateTypeSpecialty
2861NVMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316929219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ROUTE 12 BLDG 449",
            "address_2": "ATTN PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 GRUNNION AVE",
            "address_2": "BRANCH DENTAL CLINIC",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495050",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "2861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.