Individual provider Active NPI

John S Scovic, D.D.S.

  • Dentist
  • Monroe, CT
National Provider Identifier
1962629774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
009399 Issued in CT
Practice address
324 Elm St
Suite 202a
Monroe, CT 06468-2280
Phone
(203) 268-5051
Fax
(203) 268-7988
NPI assigned
Apr 20, 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
Dentist 122300000X 009399 CT Primary

Addresses

Primary practice location

324 Elm St
Suite 202a
Monroe, CT 06468-2280

Mailing address

324 Elm St
Suite 202a
Monroe, CT 06468-2280
Phone (203) 268-5051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009399CTMDDentist
9399CTMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962629774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 ELM ST",
            "address_2": "SUITE 202A",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682280",
            "telephone_number": "203-268-5051",
            "fax_number": "203-268-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ELM ST",
            "address_2": "SUITE 202A",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682280",
            "telephone_number": "203-268-5051",
            "fax_number": "203-268-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOVIC",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

Verify at the official NPI Registry.