Chris S Mirucki, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

009730 Issued in CT

Practice address

263 Farmington Ave
Uchc - Dental Clinic #2
Farmington, CT 06032-1956

Phone

(860) 679-3261

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1619136454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "UCHC - DENTAL CLINIC #2",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956",
            "telephone_number": "860-679-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "UCHC - DENTAL CLINIC #2",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321956",
            "telephone_number": "860-679-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRUCKI",
        "first_name": "CHRIS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miora Health
• Mustansar Mir, M.D
• Pamela J Miranda, BS RPH
• Allie Katherine Mirek, DO
• Seyedeh Pegah Mirmalek
• Faryal Sardar Mirza, MD
• Adrienne Vyse Miscimarra, PSY.D.
• Tanisha Mishra
• Ashley J Mitchell, MD
• Megan T Mitchell, PHARMD

• Dentist in Farmington, CT
• Providers in Farmington, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.