Individual provider Active NPI

Michael Louis Nero, D.M.D.

  • General Practice Dentistry
  • Somers, CT
National Provider Identifier
1366412868
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18509 Issued in MA
Practice address
646 Main St
Somers, CT 06071-2119
Phone
(860) 749-9911
Fax
(860) 749-0284
NPI assigned
Jan 25, 2006
Last updated
May 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2008

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 18509 MA Primary

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

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
I20150601000765 CT Order and Referring Only - DentistPractitioner - Dentist 7416278668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18509MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1366412868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "address_2": "P. O. BOX 506",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060712119",
            "telephone_number": "860-749-9911",
            "fax_number": "860-749-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060712119",
            "telephone_number": "860-749-9911",
            "fax_number": "860-749-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERO",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, CT

Sources for this page

Verify at the official NPI Registry.