Organization Active NPI

Quinnipiac Endo, PLLC

  • Endodontics
  • Wallingford, CT
National Provider Identifier
1487364063
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
QUINNIPIAC ENDO, PLLC
Practice address
850 North Main St. Ext.
BLDG. 2, Suite D3
Wallingford, CT 06492
Phone
(203) 284-9945
Fax
(203) 294-4869
NPI assigned
Dec 5, 2022
Last updated
Dec 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Carla Thiede
Title
Practice Administrator
Phone
(203) 284-9945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

850 North Main St. Ext.
BLDG. 2, Suite D3
Wallingford, CT 06492

Mailing address

850 North Main St. Ext.
BLDG. 2, Suite D3
Wallingford, CT 06492
Phone (203) 284-9945

National Provider Directory

National Provider Directory

Locations

850 N Main Street Ext
Ste 2D3
Wallingford, CT 06492
Phone (203) 284-9945

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1487364063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 NORTH MAIN ST. EXT.",
            "address_2": "BLDG. 2, SUITE D3",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-9945",
            "fax_number": "203-294-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 NORTH MAIN ST. EXT.",
            "address_2": "BLDG. 2, SUITE D3",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "06492",
            "telephone_number": "203-284-9945",
            "fax_number": "203-294-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINNIPIAC ENDO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "THIEDE",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "203-284-9945"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.