Individual provider Active NPI

Joseph Michael Romanelli, DDS

  • Dentist
  • Fairfield, CT
National Provider Identifier
1649492117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6716 Issued in CT
Practice address
1411 Black Rock Tpke
Fairfield, CT 06825-4142
Phone
(203) 384-6389
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 6716 CT Primary

Addresses

Primary practice location

1411 Black Rock Tpke
Fairfield, CT 06825-4142

Mailing address

907 Mill Hill Rd
Southport, CT 06890-3013
Phone (203) 254-8267

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
6716CTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649492117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 MILL HILL RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068903013",
            "telephone_number": "203-254-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254142",
            "telephone_number": "203-384-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANELLI",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "6716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • 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.