Walter Pierog DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

006392 Issued in CT

Legal business name

WALTER PIEROG DMD

Practice address

866 Foster Street Ext
South Windsor, CT 06074-2116

Phone

(860) 644-4209

Fax

(860) 644-6646

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Walter Pierog, DMDNPI 1285643361

Title

Owner

Phone

(860) 644-4209

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Walter Pierog, D.M.D.

  • General Practice Dentistry
  • South Windsor, CT
  • NPI 1285643361
  NPD (past) Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477681237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 FOSTER STREET EXT",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742116",
            "telephone_number": "860-644-4209",
            "fax_number": "860-644-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 FOSTER STREET EXT",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742116",
            "telephone_number": "860-644-4209",
            "fax_number": "860-644-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER PIEROG DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIEROG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-644-4209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "006392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1223G0001X",
            "identifier": "1285643361",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vipul Dua, MD, LLC
• Ryan Voelker, PHARMD
• John Henry Walker, M.D.
• Bonnie J Walsh, LCSW
• Myles Walsh, LMSW
• Gina Waltos, COTA/L
• Alexis Kyra Warren, CNM
• Sheronda Watts
• WBC Connecticut East, LLC
• Anne-Katrin U Weischedel, M.D.

• 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 Aug 22, 2020; 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.