Individual provider Active NPI

David Ochola, DMD

  • Dentist
  • Enfield, CT
National Provider Identifier
1689757320
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
008210 Issued in CT
Practice address
118 Elm St Ste 3
Enfield, CT 06082-3732
Phone
(860) 749-6088
Fax
(860) 749-6078
NPI assigned
Oct 24, 2006
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 008210 CT Primary

Addresses

Primary practice location

118 Elm St Ste 3
Enfield, CT 06082-3732

Mailing address

118 Elm St Ste 3
Enfield, CT 06082-3732
Phone (860) 749-6088

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
I20160125000900 CT Order and Referring Only - DentistPractitioner - Dentist 6305149428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008210CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1689757320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 ELM ST STE 3",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823732",
            "telephone_number": "860-749-6088",
            "fax_number": "860-749-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 ELM ST STE 3",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823732",
            "telephone_number": "860-749-6088",
            "fax_number": "860-749-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCHOLA",
        "first_name": "DAVID",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "008210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.