NPIMap

Organization Active NPI

Shore Endodontics

  • Endodontics
  • Cos Cob, CT
National Provider Identifier
1770020042
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
046687 Issued in CT
Legal business name
SHORE ENDODONTICS
Practice address
40 E Putnam Ave
Cos Cob, CT 06807-2600
Phone
(203) 625-7686
NPI assigned
Jan 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Nick Mastromihalis
Title
Owner/Dentist
Phone
(203) 625-7686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 046687 CT Primary

Addresses

Primary practice location

40 E Putnam Ave
Cos Cob, CT 06807-2600

Mailing address

40 E Putnam Ave
Cos Cob, CT 06807-2600
Phone (203) 625-7686

National Provider Directory

National Provider Directory

Locations

40 E Putnam Ave
Cos Cob, CT 06807
Phone (203) 622-4243

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1770020042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E PUTNAM AVE",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072600",
            "telephone_number": "203-625-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E PUTNAM AVE",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072600",
            "telephone_number": "203-625-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "MASTROMIHALIS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "203-625-7686"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CT",
            "license": "046687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.