Individual provider Active NPI

Perry Stuart Kest, DDS

  • General Practice Dentistry
  • Southbury, CT
National Provider Identifier
1326260258
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5118 Issued in CT
Practice address
250 Main Street South
Southbury, CT 06488
Phone
(203) 264-9606
Fax
(203) 264-4288
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5118 CT Primary

Addresses

Primary practice location

250 Main Street South
Southbury, CT 06488

Mailing address

30 Woodland Rd
Middlebury, CT 06762
Phone (203) 758-8109

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150720001584 CT Order and Referring Only - DentistPractitioner - Dentist 7012220056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5118CTMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326260258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WOODLAND RD",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "06762",
            "telephone_number": "203-758-8109",
            "fax_number": "203-264-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAIN STREET SOUTH",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "06488",
            "telephone_number": "203-264-9606",
            "fax_number": "203-264-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEST",
        "first_name": "PERRY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

Verify at the official NPI Registry.