Brian Amoroso, D.D.S.
Individual provider Active NPI Endodontics · Fairfield, CT
NPI 1982824397 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982824397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 008066 (CT)
- Practice address
- 1191 Post Road
First Floor
Fairfield, CT 06824-6007 - Phone
- (203) 255-0099
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160521000070 | CT | Order and Referring Only - Dentist |
2466741061 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008066 | CT | MD | Endodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 008066 | CT | Yes |
Addresses
Primary practice location
1191 Post Road
First Floor
Fairfield, CT 06824-6007
Mailing address
1191 Post Rd
First Floor
Fairfield, CT 06824-6007
Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.