Carl P. Prota, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6984 Issued in CT

Practice address

1367 N High St
East Haven, CT 06512-1155

Phone

(203) 468-8007

Fax

(203) 468-9121

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• East Haven General and Implant Dentistry, PLLC

  • General Practice Dentistry
  • East Haven, CT
  • NPI 1679363618
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922197896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 N HIGH ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065121155",
            "telephone_number": "203-468-8007",
            "fax_number": "203-468-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 N HIGH ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065121155",
            "telephone_number": "203-468-8007",
            "fax_number": "203-468-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTA",
        "first_name": "CARL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latrice Peterson
• Austin Phelan, LPC
• Physiotherapy Associates Inc
• Keith Pirraglia, BCBA, LBA
• Domanice Poindexter, ACNPC-AG
• Psychiatric Treatment & Resource Center Inc.
• R.E.Steller,D.M.D.,P.C.
• Rai of Sonshine Wellness
• Roberto Alex Ramos Jr.
• Danuta Malgorzata Reczek, DPM

• General Practice Dentistry in East Haven, CT
• Providers in East Haven, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.