Individual provider Active NPI

Donald Bohdan Zalucky, DDS

  • General Practice Dentistry
  • Wilton, CT
National Provider Identifier
1528174992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
005444 Issued in CT
Practice address
142 Old Ridgefield Rd
Ste 204
Wilton, CT 06897
Phone
(203) 762-7300
Fax
(203) 762-7309
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 005444 CT Primary

Addresses

Primary practice location

142 Old Ridgefield Rd
Ste 204
Wilton, CT 06897

Mailing address

142 Old Ridgefield Rd
Ste 204
Wilton, CT 06897
Phone (203) 762-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005444CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528174992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 OLD RIDGEFIELD RD",
            "address_2": "STE 204",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "06897",
            "telephone_number": "203-762-7300",
            "fax_number": "203-762-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 OLD RIDGEFIELD RD",
            "address_2": "STE 204",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "06897",
            "telephone_number": "203-762-7300",
            "fax_number": "203-762-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALUCKY",
        "first_name": "DONALD",
        "middle_name": "BOHDAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "005444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.