Individual provider Active NPI

Alexander Tumeniuk, D.M.D.

  • General Practice Dentistry
  • Milford, CT
National Provider Identifier
1861584575
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
CT007423 Issued in CT
Practice address
345 Boston Post Rd
Milford, CT 06460-2528
Phone
(203) 876-2696
Fax
(203) 877-6159
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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 CT007423 CT Primary

Addresses

Primary practice location

345 Boston Post Rd
Milford, CT 06460-2528

Mailing address

345 Boston Post Rd
Milford, CT 06460-2528
Phone (203) 799-3693

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
I20160203000927 CT Order and Referring Only - DentistPractitioner - Dentist 6608170188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT007423CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1861584575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BOSTON POST RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064602528",
            "telephone_number": "203-799-3693",
            "fax_number": "203-877-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BOSTON POST RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064602528",
            "telephone_number": "203-876-2696",
            "fax_number": "203-877-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMENIUK",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT007423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.