Michael T Goupil, D.D.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

007846 Issued in CT

Practice address

263 Farmington Ave
Farmington, CT 06030-0001

Phone

(860) 679-3300

Fax

(860) 679-1099

NPI assigned

Jun 17, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1407851116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "MC3915",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060303915",
            "telephone_number": "860-679-2808",
            "fax_number": "860-679-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-3300",
            "fax_number": "860-679-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUPIL",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CT",
            "license": "007846",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "007846",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2078469",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alanna Jazmine Gordon, DO
• Barry Gordon, LCSW
• Amanda Brady Watters Gorman, NP, RN
• Ryan A Gorman, D.O
• Kaitlin Goulet
• Brooke Gouveia, APRN
• Mary Gover, MA
• Zachary Grace
• Morgan Graham
• Martha K Grajewski, PA-C

• Oral & Maxillofacial Surgery (D.M.D.) in Farmington, CT
• Providers in Farmington, CT by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.