Individual provider Active NPI

Kevin Sean McLaughlin, D.M.D.

  • Oral and Maxillofacial Pathology Dentistry
  • Norwalk, CT
National Provider Identifier
1669518932
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
006173 Issued in CT
Practice address
148 East Ave
Suite 2F
Norwalk, CT 06851-5721
Phone
(203) 866-0061
Fax
(203) 866-4352
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 006173 CT Primary

Addresses

Primary practice location

148 East Ave
Suite 2F
Norwalk, CT 06851-5721

Mailing address

148 East Ave
Suite 2F
Norwalk, CT 06851-5721
Phone (203) 866-0061

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
I20160928000006 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4688681125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003173CTMDProfessional Counselor
6173CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services, LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1669518932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "address_2": "SUITE 2F",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721",
            "telephone_number": "203-866-0061",
            "fax_number": "203-866-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "address_2": "SUITE 2F",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721",
            "telephone_number": "203-866-0061",
            "fax_number": "203-866-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "KEVIN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CT",
            "license": "006173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.