Individual provider Active NPI

Joseph Kuzmic, D.D.S.

  • General Practice Dentistry
  • Mystic, CT
National Provider Identifier
1962556712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8531 Issued in CT
Practice address
117 Cow Hill Rd
Mystic, CT 06355-1449
Phone
(860) 536-4951
Fax
(860) 572-1409
NPI assigned
Jan 22, 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
General Practice Dentistry 1223G0001X 8531 CT Primary

Addresses

Primary practice location

117 Cow Hill Rd
Mystic, CT 06355-1449

Mailing address

117 Cow Hill Rd
Mystic, CT 06355-1449
Phone (860) 536-4951

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
I20150709000977 CT Order and Referring Only - DentistPractitioner - Dentist 1557673241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8531CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mystic Dental Group, P.C. General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962556712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 COW HILL RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551449",
            "telephone_number": "860-536-4951",
            "fax_number": "860-572-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 COW HILL RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551449",
            "telephone_number": "860-536-4951",
            "fax_number": "860-572-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZMIC",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.