Active NPI
Quinnipiac Endo, PLLC
- Endodontics
- Wallingford, CT
National Provider Identifier
1487364063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- 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, 2022
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 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 DirectoryLocations
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.
-
- Endodontics
- Wallingford, CT
- NPI 1740402726
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.