Dr Dental of Norwalk PC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

010025 Issued in CT

Legal business name

DR DENTAL OF NORWALK PC

Practice address

360 Connecticut Ave
Norwalk, CT 06854-1824

Phone

(201) 725-0372

NPI assigned

Oct 27, 2011

Organization subpart

No

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

Authorized official

Name

Arthur Revechkis

Title

Managing Partner

Phone

(201) 725-0372

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Dental Doing business as

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1598041154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541824",
            "telephone_number": "201-725-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541824",
            "telephone_number": "201-725-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DENTAL OF NORWALK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "REVECHKIS",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "201-725-0372"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "CT",
            "license": "010025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010025",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Drift Counseling and Wellness, LLC
• Rachel Drost

• Public Health Dentistry in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Public Health Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.