Individual provider Active NPI

Michael S. Wolfman, D.M.D.

  • Pediatric Dentistry
  • Norwalk, CT
National Provider Identifier
1487718003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
004685 Issued in CT
Practice address
149 East Ave
Norwalk, CT 06851-5711
Phone
(203) 838-4191
Fax
(203) 838-0670
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

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
Pediatric Dentistry 1223P0221X 004685 CT Primary

Addresses

Primary practice location

149 East Ave
Norwalk, CT 06851-5711

Mailing address

149 East Ave
Norwalk, CT 06851-5711
Phone (203) 838-4191

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
004685CTMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487718003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 EAST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515711",
            "telephone_number": "203-838-4191",
            "fax_number": "203-838-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 EAST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515711",
            "telephone_number": "203-838-4191",
            "fax_number": "203-838-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFMAN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "004685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.