Individual provider Active NPI

Virginia M Graicerstein, DDS

  • General Practice Dentistry
  • Norwalk, CT
National Provider Identifier
1629197124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009183 Issued in CT
Practice address
6 Eversley Ave
Norwalk, CT 06851-5817
Phone
(203) 838-2588
Fax
(203) 838-1040
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 009183 CT Primary

Addresses

Primary practice location

6 Eversley Ave
Norwalk, CT 06851-5817

Mailing address

6 Eversley Ave
Norwalk, CT 06851-5817
Phone (203) 838-2588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20150917001954 CT Order and Referring Only - DentistPractitioner - Dentist 8022325448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009183CTMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629197124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EVERSLEY AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515817",
            "telephone_number": "203-838-2588",
            "fax_number": "203-838-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EVERSLEY AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515817",
            "telephone_number": "203-838-2588",
            "fax_number": "203-838-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAICERSTEIN",
        "first_name": "VIRGINIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.