Ammar Idlibi, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

P07893 Issued in CT

Practice address

733 Terryville Ave
Bristol, CT 06010-4034

Phone

(860) 584-0441

Fax

(860) 516-8918

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kids Dental Care, LLC

  • Pediatric Dentistry
  • Bristol, CT
  • NPI 1619171790
  NPD (past) Authorized official
• Kids Dental Care Anesthesia, LLC

  • Anesthesiology Physician
  • Bristol, CT
  • NPI 1104172881
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1376569012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 TERRYVILLE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104034",
            "telephone_number": "860-584-0441",
            "fax_number": "860-516-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 TERRYVILLE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104034",
            "telephone_number": "860-584-0441",
            "fax_number": "860-516-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDLIBI",
        "first_name": "AMMAR",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "P07893",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "PO7893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Rieley Hunt, APRN
• Steven Hunter, MD
• Louis Hurwitz
• Rebecca Iannucci, APRN FNP-BC
• Adnan Idlibi, DMD
• Ilera Medical LLC
• Im Opco LLC
• In Bloom Counseling, LLC
• Dorothy Ingram
• Rosalyn A Ingram, APRN

• Pediatric Dentistry in Bristol, CT
• Providers in Bristol, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.