Mark D. Rubin, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

04599 Issued in CT

Practice address

469 Buckland Rd
South Windsor, CT 06074-3737

Phone

(860) 644-2136

NPI assigned

Mar 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427175256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743737",
            "telephone_number": "860-644-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743737",
            "telephone_number": "860-644-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "04599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Jay Roth, M.D.
• Lani Dove Roth, LMT
• Stacey Roy
• Rubin Dental Practice
• Rubin Family Dentistry & Associates, LLC
• Satoko Ono Rubin, D.M.D., M.D.SC.
• Todd Barry Rubin, D.M.D.
• Russo Therapeutics, LLC
• Beata Russo, M.ED, OTR/L
• Anna Ryan, DO

• General Practice Dentistry in South Windsor, CT
• Providers in South Windsor, CT by specialty
• General Practice Dentistry in Connecticut

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.