Individual provider Active NPI

Donald R. Drouin, D.D.S.

  • General Practice Dentistry
  • Cromwell, CT
National Provider Identifier
1457577082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4979 Issued in CT
Practice address
26 Shunpike Rd
Cromwell, CT 06416-2442
Phone
(860) 635-2344
Fax
(860) 632-2097
NPI assigned
Apr 18, 2007
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
General Practice Dentistry 1223G0001X 4979 CT Primary

Addresses

Primary practice location

26 Shunpike Rd
Cromwell, CT 06416-2442

Mailing address

26 Shunpike Rd
Cromwell, CT 06416-2442
Phone (860) 635-2344

Other identifiers 1

IdentifierTypeStateIssuer
4979OtherCTDENTAL LICENSE NUMBER

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

LicenseStateTypeSpecialty
4979CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457577082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162442",
            "telephone_number": "860-635-2344",
            "fax_number": "860-632-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162442",
            "telephone_number": "860-635-2344",
            "fax_number": "860-632-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROUIN",
        "first_name": "DONALD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "4979",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, 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.

Verify at the official NPI Registry.