Kenneth Robert Capozzi, DDS
Individual provider Active NPI General Practice Dentistry · Prospect, CT
NPI 1497817464 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497817464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8439CT (CT)
- Practice address
- 2 Summit Rd
Prospect, CT 06712 - Phone
- (203) 758-4224
- Fax
- (203) 758-6399
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150708002720 | CT | Order and Referring Only - Oral Surgery |
9537471271 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8439CT | CT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth R. Capozzi DDS LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8439CT | CT | Yes |
Addresses
Primary practice location
2 Summit Rd
Prospect, CT 06712
Mailing address
PO Box 7021
Prospect, CT 06712
Phone (203) 758-4224
Other providers in Prospect, CT
- John D Bianchini
- Kimberly Louise Bianchini
- Heather Joyce Bloechle
- Dulce Duarte Branco
- Calm and Centered Counseling LLC
- Michele Ann Charland
- Natasha Chokshi
- Christian Counseling of Greater Waterbury
- Christian Counseling of Greater Waterbury
- Denisa Emilia Ciucci
All providers in Prospect, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.