Individual provider Active NPI

Kayla Suzanne Mazer, D.D.S.

  • General Practice Dentistry
  • Stamford, CT
National Provider Identifier
1497819700
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008283 Issued in CT
Practice address
61 Fourth Street
Stamford, CT 06905
Phone
(203) 348-3756
Fax
(203) 348-8675
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 008283 CT Primary

Addresses

Primary practice location

61 Fourth Street
Stamford, CT 06905

Mailing address

61 Fourth Street
Stamford, CT 06905
Phone (203) 348-3756

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190123002804 CT Order and Referring Only - DentistPractitioner - Dentist 4486991809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008283CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1497819700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 FOURTH STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06905",
            "telephone_number": "203-348-3756",
            "fax_number": "203-348-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 FOURTH STREET",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06905",
            "telephone_number": "203-348-3756",
            "fax_number": "203-348-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZER",
        "first_name": "KAYLA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.