Individual provider Active NPI

Ian C Tingey, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Farmington, CT
National Provider Identifier
1427075381
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7062 Issued in CT
Practice address
291 Farmington Ave
Farmington, CT 06032-1925
Phone
(860) 678-7528
Fax
(860) 678-7933
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7062 CT Primary

Addresses

Primary practice location

291 Farmington Ave
Farmington, CT 06032-1925

Mailing address

291 Farmington Ave
Farmington, CT 06032-1925
Phone (860) 678-7528

Other identifiers 1

IdentifierTypeStateIssuer
2070621MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111101000478 CT Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 8729251079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
University of Connecticut School of Dental Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Maxillofacial Surgeons LLCGroup PAC ID 2062317134, 4 clinicians

Practice addresses (Care Compare)

291 Farmington Ave
Farmington, CT 06032-1925
Phone (860) 678-7528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7062CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Maxillofacial Surgeons, LLC Oral and Maxillofacial Surgery CurrentSince Dec 10, 1994 Accepting new patients

Locations

291 Farmington Ave
Farmington, CT 06032
Phone (860) 677-8666

291 Farmington Ave
Ste 2
Farmington, CT 06032
Phone (860) 678-7528

507 Hopmeadow St
Simsbury, CT 06070
Phone (860) 658-0446

663 E Main St
Torrington, CT 06790
Phone (860) 496-6036

415 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 529-3937

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.

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": "1183852800000",
    "number": "1427075381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321925",
            "telephone_number": "860-678-7528",
            "fax_number": "860-678-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321925",
            "telephone_number": "860-678-7528",
            "fax_number": "860-678-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGEY",
        "first_name": "IAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "7062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070621",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.