Active NPI
Stephen David Lipman, D.M.D.
- General Practice Dentistry
- Windsor, CT
National Provider Identifier
1407873334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6517
- Practice address
- 230 Broad St
Windsor, CT 06095-2925 - Phone
- (860) 688-4634
- Fax
- (860) 688-7824
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6517 | CT | Primary |
Addresses
Primary practice location
230 Broad St
Windsor, CT 06095-2925
Mailing address
230 Broad St
Windsor, CT 06095-2925
Phone (860) 688-4634
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6517 | CT | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dentistry of Windsor PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Windsor, CT
- NPI 1770758674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1407873334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 BROAD ST",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952925",
"telephone_number": "860-688-4634",
"fax_number": "860-688-7824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 BROAD ST",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952925",
"telephone_number": "860-688-4634",
"fax_number": "860-688-7824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPMAN",
"first_name": "STEPHEN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "6517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.