NPIMap

Organization Active NPI

Fedorciw and Massoumi LLC

  • Dental Clinic/Center
  • Cromwell, CT
National Provider Identifier
1396866927
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8806 Issued in CT
Legal business name
FEDORCIW AND MASSOUMI LLC
Practice address
26 Shunpike Rd
Cromwell, CT 06416-2442
Phone
(860) 635-4666
Fax
(860) 635-3621
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mehran Massoumi, DDSNPI 1730204371
Title
Owner
Phone
(860) 635-4666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8806 CT Primary

Addresses

Primary practice location

26 Shunpike Rd
Cromwell, CT 06416-2442

Mailing address

26 Shunpike Rd
Cromwell, CT 06416-2442
Phone (860) 635-4666

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396866927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162442",
            "telephone_number": "860-635-4666",
            "fax_number": "860-635-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162442",
            "telephone_number": "860-635-4666",
            "fax_number": "860-635-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDORCIW AND MASSOUMI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASSOUMI",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-635-4666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "8806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.