Individual provider Active NPI

Brad A Heim, DMD

  • General Practice Dentistry
  • Glastonbury, CT
National Provider Identifier
1699823732
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
006781 Issued in CT
Practice address
36 Welles St
Suite 240
Glastonbury, CT 06033-2080
Phone
(860) 633-2031
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 006781 CT Primary

Addresses

Primary practice location

36 Welles St
Suite 240
Glastonbury, CT 06033-2080

Mailing address

36 Welles St
Suite 240
Glastonbury, CT 06033-2080
Phone (860) 633-2031

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
006781CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Heim & Carroll DMD LLC General Practice CurrentSince Jan 1, 2004 Accepting new patients

Locations

36 Welles St
Ste 240
Glastonbury, CT 06033
Phone (860) 633-2031

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699823732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WELLES ST",
            "address_2": "SUITE 240",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332080",
            "telephone_number": "860-633-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WELLES ST",
            "address_2": "SUITE 240",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332080",
            "telephone_number": "860-633-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIM",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "006781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, 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.