Active NPI
Edward Juozokas, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Enfield, CT
National Provider Identifier
1770675951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 005401
- Practice address
- 115 Elm St
Suite 209
Enfield, CT 06082-3712 - Phone
- (860) 741-2277
- Fax
- (860) 253-0170
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 005401 | CT | Primary |
Addresses
Primary practice location
115 Elm St
Suite 209
Enfield, CT 06082-3712
Mailing address
115 Elm St
Suite 209
Enfield, CT 06082-3712
Phone (860) 741-2277
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005401 | CT | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McNally Brothers | Oral and Maxillofacial Surgery | Current | Accepting new patients |
Locations
115 Elm St
Enfield, CT 06082
Phone (860) 696-2695
115 Elm St
Ste 209
Enfield, CT 06082
Phone (860) 641-2277
75 Van Deene Ave
Ste 201
West Springfield, MA 01089
Phone (413) 788-9621
Organizations & group practices 1
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": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770675951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 ELM ST",
"address_2": "SUITE 209",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823712",
"telephone_number": "860-741-2277",
"fax_number": "860-253-0170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 ELM ST",
"address_2": "SUITE 209",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823712",
"telephone_number": "860-741-2277",
"fax_number": "860-253-0170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUOZOKAS",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CT",
"license": "005401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.