Individual provider Active NPI

Amuri Barbosa, DENTAL HYGIENIST

  • Dental Hygienist
  • Bridgeport, CT
National Provider Identifier
1891940656
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
007180 Issued in CT
Practice address
64 Black Rock Ave
Bridgeport, CT 06605-1200
Phone
(203) 579-5000
Fax
(203) 579-5113
NPI assigned
Nov 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 007180 CT Primary

Addresses

Primary practice location

64 Black Rock Ave
Bridgeport, CT 06605-1200

Mailing address

471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 333-6864

Other identifiers 1

IdentifierTypeStateIssuer
007180OtherCTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
007180CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1891940656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 BARNUM AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082409",
            "telephone_number": "203-333-6864",
            "fax_number": "203-332-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLACK ROCK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051200",
            "telephone_number": "203-579-5000",
            "fax_number": "203-579-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "AMURI",
        "credential": "DENTAL HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "007180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "007180",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.