Individual provider Active NPI

Teresa Elizabeth Bunn, D.D.S.

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1871713735
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008361 Issued in CT
Practice address
428 Columbus Ave
New Haven, CT 06519-1233
Phone
(203) 503-3250
NPI assigned
Apr 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 008361 CT Primary

Addresses

Primary practice location

428 Columbus Ave
New Haven, CT 06519-1233

Mailing address

30 Magnolia Rd
Milford, CT 06461-9126
Phone (203) 877-3006

Other names 1

  • Teresa Bunn Leparik Other name

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
I20200424001917 CT Practitioner - Dentist 6800226325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008361CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yale New Haven Hospital CurrentSince Mar 23, 2020 Accepting new patients

Locations

1 Long Wharf Dr
Ste 404
New Haven, CT 06511
Phone (203) 688-2464

100 Church St S
Ste 2
New Haven, CT 06519

20 York St
North Haven, CT 06510
Phone (203) 688-2433

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871713735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAGNOLIA RD",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064619126",
            "telephone_number": "203-877-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "TERESA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "LEPARIK",
            "middle_name": "BUNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.