NPIMap

Organization Active NPI

Fairfield Periodontics, LLC

  • Periodontics
  • Fairfield, CT
National Provider Identifier
1508069451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
FAIRFIELD PERIODONTICS, LLC
Practice address
71 Beach Rd
Fairfield, CT 06824-6001
Phone
(203) 255-7771
Fax
(203) 255-5753
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Cary Alan Shapoff, DDS
Title
Managing Partner
Phone
(203) 255-7771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

71 Beach Rd
Fairfield, CT 06824-6001

Mailing address

71 Beach Rd
Fairfield, CT 06824-6001
Phone (203) 255-7771

National Provider Directory

National Provider Directory

Locations

71 Beach Rd
Fairfield, CT 06824
Phone (203) 255-7771

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508069451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BEACH RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246001",
            "telephone_number": "203-255-7771",
            "fax_number": "203-255-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 BEACH RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246001",
            "telephone_number": "203-255-7771",
            "fax_number": "203-255-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAPOFF",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "203-255-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.