Individual provider Active NPI

John P Plachtyna, D.D.S.

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1841203072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
006521 Issued in CT
Practice address
123 York St
Suite 4L
New Haven, CT 06511-5614
Phone
(203) 781-8051
Fax
(203) 781-8089
NPI assigned
Aug 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 006521 CT Primary

Addresses

Primary practice location

123 York St
Suite 4L
New Haven, CT 06511-5614

Mailing address

123 York St
Suite 4L
New Haven, CT 06511-5614
Phone (203) 781-8051

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
I20150803000031 CT Order and Referring Only - DentistPractitioner - Dentist 6002120235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006521CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New Haven Dental Group General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841203072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 YORK ST",
            "address_2": "SUITE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115614",
            "telephone_number": "203-781-8051",
            "fax_number": "203-781-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 YORK ST",
            "address_2": "SUITE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115614",
            "telephone_number": "203-781-8051",
            "fax_number": "203-781-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACHTYNA",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "006521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.