Individual provider Active NPI

Charles Joel Applebaum, DDS

  • Dentist
  • Fairfield, CT
National Provider Identifier
1891843207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4292 Issued in CT
Practice address
841 Stratfield Rd
Fairfield, CT 06825-1651
Phone
(203) 333-3381
Fax
(203) 333-4487
NPI assigned
Jan 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Dentist 122300000X 4292 CT Primary

Addresses

Primary practice location

841 Stratfield Rd
Fairfield, CT 06825-1651

Mailing address

841 Stratfield Rd
Fairfield, CT 06825-1651
Phone (203) 333-3381

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
I20160701001526 CT Order and Referring Only - DentistPractitioner - Dentist 6002108545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4292CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles J.Applebaum DDS Dentist Past Accepting new patients

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891843207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 STRATFIELD RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251651",
            "telephone_number": "203-333-3381",
            "fax_number": "203-333-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 STRATFIELD RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251651",
            "telephone_number": "203-333-3381",
            "fax_number": "203-333-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLEBAUM",
        "first_name": "CHARLES",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "4292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.