Randall Hunt Neichin, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

5223 Issued in CT

Practice address

4699 Main St
Suite 206
Bridgeport, CT 06606

Phone

(203) 372-3575

Fax

(203) 374-2895

NPI assigned

Aug 5, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629087309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 206",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-3575",
            "fax_number": "203-374-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 206",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-3575",
            "fax_number": "203-374-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEICHIN",
        "first_name": "RANDALL",
        "middle_name": "HUNT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "5223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Periodontics in Connecticut

• 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.