Individual provider Active NPI

Dawn Allyson Bogdan, DDS

  • General Practice Dentistry
  • Bethel, CT
National Provider Identifier
1558421230
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008817 Issued in CT
Practice address
3 School Street
Bethel, CT 06801
Phone
(203) 744-1646
Fax
(203) 798-6801
NPI assigned
Dec 11, 2006
Sex
Female
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 008817 CT Primary

Addresses

Primary practice location

3 School Street
Bethel, CT 06801

Mailing address

3 School Street
Bethel, CT 06801
Phone (203) 744-1646

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
I20160216002248 CT Order and Referring Only - DentistPractitioner - Dentist 2668777400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008817CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Damian F Galbo DDS PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558421230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SCHOOL STREET",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "06801",
            "telephone_number": "203-744-1646",
            "fax_number": "203-798-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SCHOOL STREET",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "06801",
            "telephone_number": "203-744-1646",
            "fax_number": "203-798-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDAN",
        "first_name": "DAWN",
        "middle_name": "ALLYSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

Verify at the official NPI Registry.