Michael Louis Nero, D.M.D.

Individual provider Active NPI General Practice Dentistry · Somers, CT

NPI 1366412868 · NPPES record last updated May 21, 2008

Key facts

NPI
1366412868
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
18509 (MA)
Practice address
646 Main St
Somers, CT 06071-2119
Phone
(860) 749-9911
Fax
(860) 749-0284
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150601000765 CT Order and Referring Only - Dentist
Practitioner - Dentist
7416278668

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
18509MAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18509 MA Yes

Addresses

Primary practice location

646 Main St
Somers, CT 06071-2119

Mailing address

646 Main St
P. O. Box 506
Somers, CT 06071-2119
Phone (860) 749-9911

Other providers in Somers, CT

All providers in Somers, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.