Active NPI
Michael Smyle, D.D.S.
- General Practice Dentistry
- Mystic, CT
National Provider Identifier
1336293109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4127
- Practice address
- 117 Cow Hill Rd
Mystic, CT 06355-1449 - Phone
- (860) 536-4951
- Fax
- (860) 572-1409
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4127 | CT | Primary |
Addresses
Primary practice location
117 Cow Hill Rd
Mystic, CT 06355-1449
Mailing address
117 Cow Hill Rd
Mystic, CT 06355-1449
Phone (860) 536-4951
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 |
|---|---|---|---|
| 4127 | CT | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mystic Dental Group, P.C. | General Practice | 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.
-
- General Practice Dentistry
- Mystic, CT
- NPI 1376700997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336293109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 COW HILL RD",
"city": "MYSTIC",
"state": "CT",
"postal_code": "063551449",
"telephone_number": "860-536-4951",
"fax_number": "860-572-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 COW HILL RD",
"city": "MYSTIC",
"state": "CT",
"postal_code": "063551449",
"telephone_number": "860-536-4951",
"fax_number": "860-572-1409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMYLE",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "4127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mystic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.