Individual provider Active NPI

Marc Craig, D.M.D.

  • General Practice Dentistry
  • Cheshire, CT
National Provider Identifier
1629124359
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6009 Issued in CT
Practice address
1090 Meriden Waterbury Turnpike
Cheshire, CT 06450
Phone
(203) 272-8222
Fax
(203) 272-8226
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6009 CT Primary

Addresses

Primary practice location

1090 Meriden Waterbury Turnpike
Cheshire, CT 06450

Mailing address

1090 Meriden Waterbury Turnpike
Cheshire, CT 06450
Phone (203) 272-8222

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
6009CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
R a Associates of Cheshire, LLC General Practice Past Accepting new patients
Cheshire Family Dental PLLC PastSince Mar 27, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1629124359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 MERIDEN WATERBURY TURNPIKE",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-272-8222",
            "fax_number": "203-272-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 MERIDEN WATERBURY TURNPIKE",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-272-8222",
            "fax_number": "203-272-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.