NPIMap

Organization Active NPI

Simon Bangiyev DDS, MD, PC Dba Premier Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Norwalk, CT
National Provider Identifier
1861939456
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
011114 Issued in CT
Legal business name
SIMON BANGIYEV DDS, MD, PC DBA PREMIER ORAL SURGERY
Practice address
346 Main Ave
Suite H
Norwalk, CT 06851-1592
Phone
(203) 939-9390
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Dr. Simon Y Bangiyev, DDS, MDNPI 1366671281
Title
President
Phone
(203) 939-9390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 011114 CT Primary

Addresses

Primary practice location

346 Main Ave
Suite H
Norwalk, CT 06851-1592

Mailing address

346 Main Ave
Suite H
Norwalk, CT 06851-1592
Phone (203) 939-9390

National Provider Directory

National Provider Directory
Tax ID family
Simon Bangiyev DDS MD PC Dba Premier Oral Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

346 Main Ave
Ste H
Norwalk, CT 06851
Phone (203) 939-9390

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1861939456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 MAIN AVE",
            "address_2": "SUITE H",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511592",
            "telephone_number": "203-939-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 MAIN AVE",
            "address_2": "SUITE H",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511592",
            "telephone_number": "203-939-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON BANGIYEV DDS, MD, PC DBA PREMIER ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "BANGIYEV",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-939-9390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "011114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.