Active NPI
Jenny Tekla Federman, DMD
- Pediatric Dentistry
- Brookfield, CT
National Provider Identifier
1841389392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- CT00821
- Practice address
- 60 Old New Milford Rd
Ste 1D
Brookfield, CT 06804-2430 - Phone
- (203) 740-8460
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | CT00821 | CT | Primary |
Addresses
Primary practice location
60 Old New Milford Rd
Ste 1D
Brookfield, CT 06804-2430
Mailing address
60 Old New Milford Road
Ste 1D
Brookfield, CT 06776
Phone (203) 740-8460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT00821 | CT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841389392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 OLD NEW MILFORD ROAD",
"address_2": "STE 1D",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "06776",
"telephone_number": "203-740-8460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 OLD NEW MILFORD RD",
"address_2": "STE 1D",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068042430",
"telephone_number": "203-740-8460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDERMAN",
"first_name": "JENNY",
"middle_name": "TEKLA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "CT00821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.