NPIMap

Organization Active NPI

Professional Endodontics LL

  • Endodontics
  • New London, CT
National Provider Identifier
1669751939
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
PROFESSIONAL ENDODONTICS LL
Practice address
70 Howard St
Suite B
New London, CT 06320-4937
Phone
(860) 447-2572
Fax
(860) 447-2638
NPI assigned
Aug 4, 2011
Last updated
Aug 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Dr. Milos R Janicek, DMDNPI 1497923981
Title
President
Phone
(860) 447-2572

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU Primary

Addresses

Primary practice location

70 Howard St
Suite B
New London, CT 06320-4937

Mailing address

70 Howard St
Suite B
New London, CT 06320-4937
Phone (860) 447-2572

National Provider Directory

National Provider Directory

Locations

70 Howard St
Ste B
New London, CT 06320
Phone (860) 447-2572

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1669751939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 HOWARD ST",
            "address_2": "SUITE B",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204937",
            "telephone_number": "860-447-2572",
            "fax_number": "860-447-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 HOWARD ST",
            "address_2": "SUITE B",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204937",
            "telephone_number": "860-447-2572",
            "fax_number": "860-447-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ENDODONTICS LL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "JANICEK",
        "authorized_official_first_name": "MILOS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-447-2572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.