Edward Shukovsky

Primary specialty

DentistTaxonomy code 122300000X

License

005762 Issued in CT

Legal business name

EDWARD SHUKOVSKY

Practice address

1290 Summer St
Suite 3400
Stamford, CT 06905-5360

Phone

(203) 348-2411

Fax

(203) 348-5895

NPI assigned

Mar 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Edward Shukovsky, DMDNPI 1902982838

Title

Owner

Phone

(203) 348-2411

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Shukovsky, DMD

  • Dentist
  • Stamford, CT
  • NPI 1902982838
  NPD Authorized official

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1619362571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SUMMER ST",
            "address_2": "SUITE 3400",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055360",
            "telephone_number": "203-348-2411",
            "fax_number": "203-348-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 SUMMER ST",
            "address_2": "SUITE 3400",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055360",
            "telephone_number": "203-348-2411",
            "fax_number": "203-348-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD SHUKOVSKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "SHUKOVSKY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-348-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "005762",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hana Effendi

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.