Individual provider Active NPI

Bill Markantonakis, D.M.D.

  • Dentist
  • Orange, CT
National Provider Identifier
1609102755
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7651 Issued in CT
Practice address
501 Boston Post Rd
Orange, CT 06477-3567
Phone
(203) 799-3311
Fax
(203) 799-9937
NPI assigned
Oct 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7651 CT Primary

Addresses

Primary practice location

501 Boston Post Rd
Orange, CT 06477-3567

Mailing address

501 Boston Post Rd
Orange, CT 06477-3567
Phone (203) 799-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7651CTMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1609102755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773567",
            "telephone_number": "203-799-3311",
            "fax_number": "203-799-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773567",
            "telephone_number": "203-799-3311",
            "fax_number": "203-799-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKANTONAKIS",
        "first_name": "BILL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "7651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.