Individual provider Active NPI

Donald L Gardner, DMD

  • Dentist
  • Danbury, CT
National Provider Identifier
1578694857
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4611 Issued in CT
Practice address
432 Main St
Danbury, CT 06810-4730
Phone
(203) 748-2606
Fax
(203) 790-5344
NPI assigned
Mar 8, 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
Dentist 122300000X 4611 CT Primary

Addresses

Primary practice location

432 Main St
Danbury, CT 06810-4730

Mailing address

432 Main St
Danbury, CT 06810-4730
Phone (203) 748-2606

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
I20150513001353 CT Order and Referring Only - DentistPractitioner - Dentist 6002136132

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578694857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104730",
            "telephone_number": "203-748-2606",
            "fax_number": "203-790-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 MAIN ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068104730",
            "telephone_number": "203-748-2606",
            "fax_number": "203-790-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "4611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.