Individual provider Active NPI

Craig Megibow, DDS

  • General Practice Dentistry
  • Brookfield, CT
National Provider Identifier
1538207147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008793 Issued in CT
Practice address
300 Federal Rd
Suite 103
Brookfield, CT 06804-2412
Phone
(203) 775-1800
NPI assigned
Feb 3, 2007
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 008793 CT Primary

Addresses

Primary practice location

300 Federal Rd
Suite 103
Brookfield, CT 06804-2412

Mailing address

300 Federal Rd
Suite 103
Brookfield, CT 06804-2412
Phone (203) 775-1800

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
I20160107000025 CT Order and Referring Only - DentistPractitioner - Dentist 6406158534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008793CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538207147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FEDERAL RD",
            "address_2": "SUITE 103",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042412",
            "telephone_number": "203-775-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FEDERAL RD",
            "address_2": "SUITE 103",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042412",
            "telephone_number": "203-775-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGIBOW",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.