Active NPI
Sofia Martirosov, DDS
- General Practice Dentistry
- Stamford, CT
National Provider Identifier
1407992753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 008956
- Practice address
- 100 Greyrock PL
Town Center Dental
Stamford, CT 06901-3118 - Phone
- (203) 348-0300
- Fax
- (203) 324-9665
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 008956 | CT | Primary |
Addresses
Primary practice location
100 Greyrock PL
Town Center Dental
Stamford, CT 06901-3118
Mailing address
250 Gorge Rd
#23 J
Cliffside Park, NJ 07010-1301
Phone (347) 668-9645
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
| License | State | Type | Specialty |
|---|---|---|---|
| 008956 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407992753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 GORGE RD",
"address_2": "#23 J",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070101301",
"telephone_number": "347-668-9645",
"fax_number": "203-324-9665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GREYROCK PL",
"address_2": "TOWN CENTER DENTAL",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069013118",
"telephone_number": "203-348-0300",
"fax_number": "203-324-9665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIROSOV",
"first_name": "SOFIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "008956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.