Individual provider Active NPI

Benedict Rich, DDS

  • Dentist
  • Norwalk, CT
National Provider Identifier
1861510042
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
006665 Issued in CT
Practice address
6 Eversley Ave
Norwalk, CT 06851-5817
Phone
(203) 838-2588
Fax
(203) 838-1040
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 006665 CT Primary
General Practice Dentistry 1223G0001X 038826-1 NY

Addresses

Primary practice location

6 Eversley Ave
Norwalk, CT 06851-5817

Mailing address

6 Eversley Ave
Norwalk, CT 06851-5817
Phone (203) 838-2588

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
I20150522002143 CT Order and Referring Only - DentistPractitioner - Dentist 1557681020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006665CTMDDentist
038826-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1861510042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EVERSLEY AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515817",
            "telephone_number": "203-838-2588",
            "fax_number": "203-838-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EVERSLEY AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515817",
            "telephone_number": "203-838-2588",
            "fax_number": "203-838-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "BENEDICT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "006665",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038826-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.