Individual provider Active NPI

Haissam Ramadan, D.M.D.

  • Dentist
  • Danbury, CT
National Provider Identifier
1467723734
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105555 Issued in CT
Practice address
57 North St Ste 318
Danbury, CT 06810-5628
Phone
(203) 826-9299
NPI assigned
Jan 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105555 CT Primary

Addresses

Primary practice location

57 North St Ste 318
Danbury, CT 06810-5628

Mailing address

175 Canton St
Apt B15
West Haven, CT 06516-2233
Phone (203) 795-0000

Other practice location 1

54 Main St
Suite 1
Danbury, CT 06810
Phone (203) 790-0111

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
105555CTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1467723734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CANTON ST",
            "address_2": "APT B15",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162233",
            "telephone_number": "203-795-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 NORTH ST STE 318",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105628",
            "telephone_number": "203-826-9299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Main St",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "06810",
            "country_code": "US",
            "telephone_number": "203-790-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMADAN",
        "first_name": "HAISSAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-19",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "105555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.