Active NPI
Joseph Terry Siracuse, DMD
- Endodontics
- New Haven, CT
National Provider Identifier
1356451330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 3625
- Practice address
- 265 Church St
Ste 1003
New Haven, CT 06510 - Phone
- (203) 777-6461
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 3625 | CT | Primary |
Addresses
Primary practice location
265 Church St
Ste 1003
New Haven, CT 06510
Mailing address
103 Plymouth Colony
Branford, CT 06405
Phone (203) 483-7343
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 |
|---|---|---|---|
| 3625 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356451330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 PLYMOUTH COLONY",
"city": "BRANFORD",
"state": "CT",
"postal_code": "06405",
"telephone_number": "203-483-7343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 CHURCH ST",
"address_2": "STE 1003",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "06510",
"telephone_number": "203-777-6461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIRACUSE",
"first_name": "JOSEPH",
"middle_name": "TERRY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CT",
"license": "3625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, 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.