Michael A Ungerleider, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

CT007457 Issued in CT

Practice address

41 Hartford Ave
Granby, CT 06035

Phone

(860) 653-3220

Fax

(860) 653-1982

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801918909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 HARTFORD AVE",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "06035",
            "telephone_number": "860-653-3220",
            "fax_number": "860-653-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 HARTFORD AVE",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "06035",
            "telephone_number": "860-653-3220",
            "fax_number": "860-653-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGERLEIDER",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT007457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Barry F Walsh, DC
• Mary K Wimpfheimer, LCSW

• All providers in Granby, CT
• General Practice Dentistry in Connecticut

• 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.

Verify at the official NPI Registry.