Individual provider Active NPI

Edward Juozokas, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Enfield, CT
National Provider Identifier
1770675951
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
005401 Issued in CT
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

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
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000518 CT Practitioner - Oral Surgery 0042364408 Reassigns benefits to 1 organization
Practice locations: Enfield, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005401CTMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
McNally Brothers Oral and Maxillofacial Surgery CurrentSince Jun 3, 2017 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

Verify at the official NPI Registry.