Individual provider Active NPI

Howard William Tolk, DDS

  • General Practice Dentistry
  • Fairfield, CT
National Provider Identifier
1477698199
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3697 Issued in CT
Practice address
195 Tunas Hill Cut-Off South
Fairfield, CT 06825
Phone
(203) 336-1275
Fax
(203) 335-5038
NPI assigned
Feb 20, 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 3697 CT Primary

Addresses

Primary practice location

195 Tunas Hill Cut-Off South
Fairfield, CT 06825

Mailing address

195 Tunas Hill Cut-Off South
Fairfield, CT 06825
Phone (203) 336-1275

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
I20150319001796 CT Order and Referring Only - DentistPractitioner - Dentist 3375860901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3697CTMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477698199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 TUNAS HILL CUT-OFF SOUTH",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06825",
            "telephone_number": "203-336-1275",
            "fax_number": "203-335-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 TUNAS HILL CUT-OFF SOUTH",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "06825",
            "telephone_number": "203-336-1275",
            "fax_number": "203-335-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLK",
        "first_name": "HOWARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "3697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.