Active NPI
Joseph Ross Guzzardi
- Pediatric Dentistry
- Bristol, CT
National Provider Identifier
1730487976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 010905
- Practice address
- 733 Terryville Ave
Bristol, CT 06010-4034 - Phone
- (860) 584-0441
- NPI assigned
- Mar 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 010905 | CT | Primary |
Addresses
Primary practice location
733 Terryville Ave
Bristol, CT 06010-4034
Mailing address
25 Quarry Knoll Cir
Manchester, CT 06040-7142
Phone (860) 895-7784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010905 | CT | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Dental Care Anesthesia, LLC | Past | Accepting new patients | |
| Kids Dental Care, LLC | Pediatric Dentistry | 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.
-
- Anesthesiology Physician
- Bristol, CT
- NPI 1104172881
-
- Pediatric Dentistry
- Bristol, CT
- NPI 1619171790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1730487976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 QUARRY KNOLL CIR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060407142",
"telephone_number": "860-895-7784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "733 TERRYVILLE AVE",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060104034",
"telephone_number": "860-584-0441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUZZARDI",
"first_name": "JOSEPH",
"middle_name": "ROSS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-12",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "010905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.