Individual provider Active NPI

Brian P Hurt, DMD

  • Dentist
  • Colchester, CT
National Provider Identifier
1619099603
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
CT4863 Issued in CT
Practice address
715 Middletown Rd
Colchester, CT 06415-2236
Phone
(860) 267-8889
NPI assigned
Apr 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 CT4863 CT Primary

Addresses

Primary practice location

715 Middletown Rd
Colchester, CT 06415-2236

Mailing address

5 Old Country Rd
Colchester, CT 06415-2211
Phone (860) 267-7962

Other identifiers 1

IdentifierTypeStateIssuer
CT4863OtherCTLICENSE NUMBER

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
CT4863CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Family Dental Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619099603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 OLD COUNTRY RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152211",
            "telephone_number": "860-267-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MIDDLETOWN RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152236",
            "telephone_number": "860-267-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURT",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "CT4863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "CT4863",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, CT

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.