Individual provider Active NPI

Steven Meltzer, D.M.D.

  • Periodontics
  • Bloomfield, CT
National Provider Identifier
1447379516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5407 Issued in CT
Practice address
3 Northwestern Dr
Bloomfield, CT 06002-3465
Phone
(860) 242-9468
NPI assigned
Mar 28, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Periodontics 1223P0300X 5407 CT Primary

Addresses

Primary practice location

3 Northwestern Dr
Bloomfield, CT 06002-3465

Mailing address

18 Justin LN
Wethersfield, CT 06109-2543

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160520000768 CT Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 8123317773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5407CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447379516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 JUSTIN LN",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061092543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-242-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTZER",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "5407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.