Jeffrey Joseph Scull, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

004602 Issued in CT

Practice address

136 Berlin Rd
Cromwell, CT 06416-2627

Phone

(860) 635-6445

Fax

(860) 635-8595

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578609145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-635-6445",
            "fax_number": "860-635-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-635-6445",
            "fax_number": "860-635-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULL",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "004602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Schortman, SLP
• Stanley E Schulman, DMD
• Meagan Schultz
• Josiah David Scovel, LO
• Jacqueline P Scuderi, M.A., CCC-SLP
• Rocio Alexandra Segura
• Serenity Homecare LLC
• Serenity Homecare LLC
• Fatima Florinda Serrano
• Ellen Walker Seyller, MD

• General Practice Dentistry in Cromwell, CT
• Providers in Cromwell, CT by specialty
• General Practice Dentistry in Connecticut

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.