Individual provider Active NPI

Alexander Jake McGuiness, DDS

  • Dentist
  • Norwalk, CT
National Provider Identifier
1396414207
Registry record updated Oct 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13542 Issued in CT
Practice address
761 Main Ave Ste 111
Norwalk, CT 06851-1080
Phone
(203) 908-3170
NPI assigned
Sep 13, 2021
Last updated
Oct 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 062438 NY
Dentist 122300000X 13542 CT Primary

Addresses

Primary practice location

761 Main Ave Ste 111
Norwalk, CT 06851-1080

Mailing address

30 W Court Dr
Centereach, NY 11720-2328
Phone (516) 582-2648

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

LicenseStateTypeSpecialty
13542CTMDDentist
062438NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Dental Alliance of Norwalk, PLLC CurrentSince Dec 1, 2024 Accepting new patients
MVHS Inc PastSince Sep 1, 2021 Accepting new patients
All Smiles, LLC PastSince Oct 30, 2022 Accepting new patients

Locations

761 Main Ave
Ste 111
Norwalk, CT 06851
Phone (203) 908-3170

Organizations & group practices 3

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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667001600000",
    "number": "1396414207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W COURT DR",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117202328",
            "telephone_number": "516-582-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 111",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-908-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUINESS",
        "first_name": "ALEXANDER",
        "middle_name": "JAKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2022-10-29",
        "certification_date": "2022-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062438",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "13542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2022; 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.