Organization Active NPI

Downtown Dental CT PC

  • General Practice Dentistry
  • Norwalk, CT
National Provider Identifier
1639613771
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010859 Issued in CT
Legal business name
DOWNTOWN DENTAL CT PC
Practice address
205 Main St
# 4
Norwalk, CT 06851-3530
Phone
(203) 857-1854
NPI assigned
Dec 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Dr. Yulian Aminov, DDS
Title
Dentist
Phone
(212) 203-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 010859 CT Primary

Addresses

Primary practice location

205 Main St
# 4
Norwalk, CT 06851-3530

Mailing address

205 Main St
# 4
Norwalk, CT 06851
Phone (203) 857-1854

Other identifiers 1

IdentifierTypeStateIssuer
008042136MedicaidCT

National Provider Directory

National Provider Directory

Locations

205 Main St
Ste 4
Norwalk, CT 06851
Phone (203) 857-1854

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1639613771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "address_2": "# 4",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "06851",
            "telephone_number": "203-857-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAIN ST",
            "address_2": "# 4",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068513530",
            "telephone_number": "203-857-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN DENTAL CT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "AMINOV",
        "authorized_official_first_name": "YULIAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "212-203-1611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008042136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.