Jonathan Fisk, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

10965 Issued in CT

Practice address

881 Whalley Ave
New Haven, CT 06515-1728

Phone

(203) 374-1911

NPI assigned

Jul 3, 2013

Last updated

Jul 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1811337975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 WHALLEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 WHALLEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151728",
            "telephone_number": "203-374-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "10965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Andrew Fisher, MD, PHD
• Jessica Fisher
• Rosemarie Louise Fisher, MD
• Emily Fishman
• Deborah A Fisk, LCSW
• David Loring Fitter
• Holly A Fitting, LCMHC LCDP
• Susan Denise Fitzgerald Ely, MD, MPHTM
• Joseph Murray Fitzgerald Jr., LCSW
• Laura Fitzgerald

• Orthodontics and Dentofacial Orthopedics Dentistry in New Haven, CT
• Providers in New Haven, CT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.

Verify at the official NPI Registry.