Individual provider Active NPI

Nicholas J Borrello, DDS

  • General Practice Dentistry
  • Bethel, CT
National Provider Identifier
1730121112
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
003634 Issued in CT
Practice address
76 Stony Hill Rd
Bethel, CT 06801-3037
Phone
(203) 744-0033
Fax
(203) 744-2118
NPI assigned
Jun 12, 2006
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 003634 CT Primary

Addresses

Primary practice location

76 Stony Hill Rd
Bethel, CT 06801-3037

Mailing address

76 Stony Hill Rd
Bethel, CT 06801-3037
Phone (203) 744-0033

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
I20150709001438 CT Order and Referring Only - DentistPractitioner - Dentist 6709198419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Hill Dental Care PLLC Past Accepting new patients
Nicholas J Borrello DDS PC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730121112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 STONY HILL RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068013037",
            "telephone_number": "203-744-0033",
            "fax_number": "203-744-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 STONY HILL RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068013037",
            "telephone_number": "203-744-0033",
            "fax_number": "203-744-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRELLO",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "003634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

Verify at the official NPI Registry.