Individual provider Active NPI

Kevin Hugo Norige, D.M.D.

  • General Practice Dentistry
  • South Windsor, CT
National Provider Identifier
1700900792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5981 Issued in CT
Practice address
112 Deming St
South Windsor, CT 06074-3711
Phone
(860) 644-0113
Fax
(860) 644-5258
NPI assigned
Mar 17, 2007
Sex
Male
Sole proprietor
Yes

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 5981 CT Primary

Addresses

Primary practice location

112 Deming St
South Windsor, CT 06074-3711

Mailing address

PO Box 791
112 Deming St.
South Windsor, CT 06074-0791
Phone (860) 644-0113

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
I20150629001583 CT Order and Referring Only - DentistPractitioner - Dentist 0042522427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5981CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700900792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "address_2": "112 DEMING ST.",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060740791",
            "telephone_number": "860-644-0113",
            "fax_number": "860-644-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 DEMING ST",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743711",
            "telephone_number": "860-644-0113",
            "fax_number": "860-644-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORIGE",
        "first_name": "KEVIN",
        "middle_name": "HUGO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.