Individual provider Active NPI

Ewa Agata Cieslik, DMD

  • Dentist
  • Meriden, CT
National Provider Identifier
1528156643
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8908 Issued in CT
Practice address
35 Pleasant St
Suite 2B
Meriden, CT 06450-5786
Phone
(203) 237-6400
Fax
(203) 237-9769
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8908 CT Primary
General Practice Dentistry 1223G0001X 8908 CT

Addresses

Primary practice location

35 Pleasant St
Suite 2B
Meriden, CT 06450-5786

Mailing address

35 Pleasant St
Suite 2B
Meriden, CT 06450-5786
Phone (203) 237-6400

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
I20150402000097 CT Order and Referring Only - DentistPractitioner - Dentist 9638496557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1528156643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PLEASANT ST",
            "address_2": "SUITE 2B",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505786",
            "telephone_number": "203-237-6400",
            "fax_number": "203-237-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PLEASANT ST",
            "address_2": "SUITE 2B",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505786",
            "telephone_number": "203-237-6400",
            "fax_number": "203-237-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIESLIK",
        "first_name": "EWA",
        "middle_name": "AGATA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "8908",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.