Individual provider Active NPI

Marianne Ida Morelli, D.M.D.

  • General Practice Dentistry
  • Brookfield, CT
National Provider Identifier
1467574582
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008222 Issued in CT
Practice address
834 Federal Rd
Unit a
Brookfield, CT 06804-1830
Phone
(203) 775-6167
Fax
(203) 775-6169
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2010

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 008222 CT Primary

Addresses

Primary practice location

834 Federal Rd
Unit a
Brookfield, CT 06804-1830

Mailing address

834 Federal Rd
Unit a
Brookfield, CT 06804-1830
Phone (203) 775-6167

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150312001555 CT Order and Referring Only - Other (Non-Physician) 5799001699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008222CTMDClinical Social Worker
8222CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1467574582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 FEDERAL RD",
            "address_2": "UNIT A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041830",
            "telephone_number": "203-775-6167",
            "fax_number": "203-775-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 FEDERAL RD",
            "address_2": "UNIT A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068041830",
            "telephone_number": "203-775-6167",
            "fax_number": "203-775-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELLI",
        "first_name": "MARIANNE",
        "middle_name": "IDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.