Mark Renzi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8239 Issued in CT

Practice address

11 Churchill Rd
Newtown, CT 06470

Phone

(203) 748-5717

NPI assigned

Dec 4, 2006

Last updated

Mar 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1497813521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHURCH HILL RD",
            "address_2": "DENTAL ASSOCIATES OF CT PC",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701656",
            "telephone_number": "203-426-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHURCHILL RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "06470",
            "telephone_number": "203-748-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZI",
        "first_name": "MARK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Puglisi, D.D.S
• Jessica Ragusa, SLP
• Awilda Ramirez
• Julie Pauline Reiner, PT, DPT
• Andrea Reinhardt, LCSW
• Kelly Repicci, LPC
• Yadira Reyes, OTR
• Elle E Riazatti, DPM
• Catherine Rice, APRN
• Kevin Richardson

• General Practice Dentistry in Newtown, CT
• Providers in Newtown, 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 Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.