Individual provider Active NPI

Jamison Scotto, D.M.D.

  • Periodontics
  • Windsor, CT
National Provider Identifier
1891844080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
009282 Issued in CT
Practice address
1080 Day Hill Rd
Windsor, CT 06095-1781
Phone
(860) 683-0243
Fax
(860) 683-1157
NPI assigned
Jan 9, 2007
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
Periodontics 1223P0300X 009282 CT Primary

Addresses

Primary practice location

1080 Day Hill Rd
Windsor, CT 06095-1781

Mailing address

1080 Day Hill Rd
Windsor, CT 06095-1781
Phone (860) 683-0243

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
I20161128001003 CT Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3072892512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009282CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Periodontal & Implant Associates Periodontics Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891844080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951781",
            "telephone_number": "860-683-0243",
            "fax_number": "860-683-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 DAY HILL RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951781",
            "telephone_number": "860-683-0243",
            "fax_number": "860-683-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTTO",
        "first_name": "JAMISON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "009282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

Verify at the official NPI Registry.