Individual provider Active NPI

Thomas Anthony Valluzzo, DMD

  • Periodontics
  • Danbury, CT
National Provider Identifier
1700966306
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
5047 Issued in CT
Practice address
57 North St
Suite #318
Danbury, CT 06810-5628
Phone
(203) 794-0419
Fax
(203) 792-3954
NPI assigned
Oct 17, 2006
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
Periodontics 1223P0300X 5047 CT Primary

Addresses

Primary practice location

57 North St
Suite #318
Danbury, CT 06810-5628

Mailing address

57 North St
Suite #318
Danbury, CT 06810-5628
Phone (203) 794-0419

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
I20150523000037 CT Order and Referring Only - DentistPractitioner - Dentist 7618297193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700966306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 NORTH ST",
            "address_2": "SUITE #318",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105628",
            "telephone_number": "203-794-0419",
            "fax_number": "203-792-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 NORTH ST",
            "address_2": "SUITE #318",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105628",
            "telephone_number": "203-794-0419",
            "fax_number": "203-792-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLUZZO",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "5047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.