Individual provider Active NPI

Michael J. Caserta, D.M.D.

  • General Practice Dentistry
  • Shelton, CT
National Provider Identifier
1356300883
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7864 Issued in CT
Practice address
190 Coram Ave
Shelton, CT 06484-3347
Phone
(203) 924-4115
Fax
(203) 924-1301
NPI assigned
Mar 22, 2006
Last updated
Jul 13, 2026By the provider in NPPES
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
General Practice Dentistry 1223G0001X 7864 CT Primary

Addresses

Primary practice location

190 Coram Ave
Shelton, CT 06484-3347

Mailing address

556 Hoydens Hill Rd
Fairfield, CT 06824-1813
Phone (203) 924-4115

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
I20150710000345 CT Order and Referring Only - DentistPractitioner - Dentist 3476865049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7864CTMDMental Health Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356300883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 HOYDENS HILL RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068241813",
            "telephone_number": "203-924-4115",
            "fax_number": "203-924-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CORAM AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843347",
            "telephone_number": "203-924-4115",
            "fax_number": "203-924-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASERTA",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "7864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.