Jr Drew & Ep Raccio, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

005492 Issued in CT

Legal business name

JR DREW & EP RACCIO, D.M.D.

Practice address

256 Boston Post Rd
Waterford, CT 06385-2050

Phone

(860) 443-0861

Fax

(860) 443-6065

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward P Raccio, D.M.D.

Title

Partner

Phone

(860) 443-0861

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710019658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852050",
            "telephone_number": "860-443-0861",
            "fax_number": "860-443-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 BOSTON POST RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852050",
            "telephone_number": "860-443-0861",
            "fax_number": "860-443-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR DREW & EP RACCIO, D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RACCIO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "860-443-0861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "005492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Waterford, CT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.