Organization Active NPI

Gary Fishbein DMD LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Vernon, CT
National Provider Identifier
1629595145
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11333 Issued in CT
Legal business name
GARY FISHBEIN DMD LLC
Practice address
281 Hartford Tpke Ste 307
Vernon, CT 06066-4707
Phone
(860) 872-8331
NPI assigned
Aug 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Authorized official

Name
Dr. Gary Todd Fishbein, DMDNPI 1427200385
Title
Oral and Maxillofacial Surgeon
Phone
(860) 872-8331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 11333 CT Primary

Addresses

Primary practice location

281 Hartford Tpke Ste 307
Vernon, CT 06066-4707

Mailing address

281 Hartford Tpke Ste 307
Vernon, CT 06066-4707
Phone (860) 872-8331

Other names 1

  • East of the River Oral and Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

281 Hartford Tpke
Ste 307
Vernon, CT 06066
Phone (860) 872-8331

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503619200000",
    "number": "1629595145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE STE 307",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664707",
            "telephone_number": "860-872-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE STE 307",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664707",
            "telephone_number": "860-872-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY FISHBEIN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A",
        "authorized_official_last_name": "FISHBEIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "ORAL AND MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "860-872-8331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "11333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East of the River Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; 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.