Susan Schlussel Braun, DDS – Dentist

Key facts

NPI: 1609264357
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 006374 (CT)
Practice address: 17 Meadow PL
Old Greenwich, CT 06870-2114
Phone: (203) 698-2500
NPI assigned: Jan 5, 2015
Sex: Female
Sole proprietor: Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
036205	NY	MD	Dentist
006374	CT	MD	Physical Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	006374	CT	Yes
Dentist	122300000X	036205	NY

Addresses

Primary practice location

17 Meadow PL
Old Greenwich, CT 06870-2114

Mailing address

17 Meadow PL
Old Greenwich, CT 06870-2114
Phone (203) 698-2500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 5, 2015.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1609264357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MEADOW PL",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068702114",
            "telephone_number": "203-698-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MEADOW PL",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068702114",
            "telephone_number": "203-698-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "SUSAN",
        "middle_name": "SCHLUSSEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "006374",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "036205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Greenwich, CT

All providers in Old Greenwich, CT · Dentist in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.