Diamond Braces of Norwalk

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11275 Issued in CT

Legal business name

DIAMOND BRACES OF NORWALK

Practice address

15 Engle St
Suite 303
Englewood, NJ 07631-2936

Phone

(201) 308-8181

Fax

(201) 875-5588

NPI assigned

Jan 2, 2015

Organization subpart

No

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

Authorized official

Name

Oleg Drut, DDS

Title

Owner

Phone

(203) 857-1717

Specialties & licenses 1

Addresses

Tax ID family

Diamond Braces of Norwalk2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Diamond Braces of Norwalk Connecticut LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Norwalk, CT
  • NPI 1710386933
  NPD tax ID

Locations

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1710375498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENGLE ST",
            "address_2": "SUITE 303",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312936",
            "telephone_number": "201-308-8181",
            "fax_number": "201-875-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND BRACES OF NORWALK",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "DRUT",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-857-1717",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "11275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielaina S Derose, MD
• Patricia Desalvo, DMD
• Cassandra Phoebe Desmet
• Andy Desormes
• Diamond Braces of Norwalk
• Lauren Diener
• Digital Imaging Center, P.a.
• Digitrace Care Services Inc
• Tessa Dimasi, PA-C
• Nicole Dimiceli

• Orthodontics and Dentofacial Orthopedics Dentistry in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.