Scott Kesselman, DDS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Riverside, CT
NPI 1619254364 · NPPES record last updated Nov 9, 2011
Key facts
- NPI
- 1619254364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 008463 (CT)
- Practice address
- 1171 E Putnam Ave
Building 2, Suite C
Riverside, CT 06878-1426 - Phone
- (203) 698-0045
- NPI assigned
- Nov 9, 2011
- Sex
- Male
- 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 |
|---|---|---|---|
| 008463 | CT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 008463 | CT | Yes |
Addresses
Primary practice location
1171 E Putnam Ave
Building 2, Suite C
Riverside, CT 06878-1426
Mailing address
1171 E Putnam Ave
Building 2, Suite C
Riverside, CT 06878-1426
Phone (203) 698-0045
Other providers in Riverside, CT
- Jessica Ashley Johnson
- Elam H. Joseph
- Stephen Richard Katz
- Joseph Robert Kearns
- Mary Catherine Kelly
- Aigel Khadeeva
- Sohaib Khalid
- Joseph Kim
- Eleonora S Kishelova
- Carmen Kokkoros
All providers in Riverside, CT · Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2011. 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.