Individual provider Active NPI

Roderick Lamont Macneil, D.D.S., M.DENT.SC.

  • Periodontics
  • Farmington, CT
National Provider Identifier
1962624890
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
008549 Issued in CT
Practice address
263 Farmington Avenue
University Dentists
Farmington, CT 06030
Phone
(860) 679-3170
Fax
(860) 679-8162
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 008549 CT Primary

Addresses

Primary practice location

263 Farmington Avenue
University Dentists
Farmington, CT 06030

Mailing address

263 Farmington Avenue
University Dentists
Farmington, CT 06030-2820
Phone (860) 679-3170

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
008549CTMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1962624890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "address_2": "UNIVERSITY DENTISTS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302820",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "address_2": "UNIVERSITY DENTISTS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06030",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACNEIL",
        "first_name": "RODERICK",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.DENT.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "008549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.