Individual provider Active NPI

John E.a. Powe, DDS

  • Periodontics
  • West Haven, CT
National Provider Identifier
1699093351
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
010779 Issued in CT
Practice address
267 Center St
West Haven, CT 06516-4405
Phone
(202) 427-7416
NPI assigned
May 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025660 OH
Dental Anesthesiology 1223D0004X 010779 CT
General Practice Dentistry 1223G0001X 010779 CT
Periodontics 1223P0300X 010779 CT Primary

Addresses

Primary practice location

267 Center St
West Haven, CT 06516-4405

Mailing address

617 S Braddock Ave
Pittsburgh, PA 15221-3415
Phone (917) 564-2851

Other practice location 1

5600 Mahoning Ave
Austintown, OH 44515-2317
Phone (330) 318-3150

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
30.025660OHMDDentist
010779CTMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Belmont Eye Clinic, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1699093351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S BRADDOCK AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152213415",
            "telephone_number": "917-564-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 CENTER ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164405",
            "telephone_number": "202-427-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Mahoning Ave",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445152317",
            "country_code": "US",
            "telephone_number": "330-318-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWE",
        "first_name": "JOHN",
        "middle_name": "E.A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025660",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CT",
            "license": "010779",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010779",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "010779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.