Simon Pun, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12835 Issued in CT

Practice address

123 Farmington Ave
Bristol, CT 06010-4200

Phone

(860) 845-8872

NPI assigned

Aug 7, 2020

Last updated

Aug 7, 2020By 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

Practice roles

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.

• Ocean State Family Dental

  • General Practice Dentistry
  • Coventry, RI
  • NPI 1376483818
  NPD Authorized official
• Unity Dental Torrington LLC

  dba South Main Dental

  • Dental Clinic/Center
  • Torrington, CT
  • NPI 1922832880
  NPD (past)

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1861002487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6970 182ND ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653534",
            "telephone_number": "443-995-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104200",
            "telephone_number": "860-845-8872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 South Main Street",
            "address_purpose": "LOCATION",
            "city": "Torrington",
            "state": "CT",
            "postal_code": "06790",
            "country_code": "US",
            "telephone_number": "860-618-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUN",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "12835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Edward Propfe
• Ashley Anne Proulx, PHYSICIAN ASSISTANT
• PS Dental of Bristol (PS Dental)
• Michael Stephen Ptaszynski, MD
• Ptsma, Inc (Select Physical Therapy)
• Jennifer Quagliano
• Sarah Quayle
• Doreen A. Rackliffe, PA-C
• Heather Kristen Radawich, LCSW
• Radiologic Associates PC

• Dentist in Bristol, CT
• Providers in Bristol, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.