IDENT PC
Complete NPI Record 1194301036
Dentist - General Practice in Stamford, CT
Active since March 22, 2021
Complete NPI Dataset
This page contains the complete raw NPPES record for Ident Pc (NPI 1194301036), a dentist organization in Stamford, CT. All 27 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
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Registry File Document Utilities
- NPI: 1194301036 Field 1/27
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/27
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/27
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: IDENT PC Field 4/27
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: 200 WESTAGE BUSINESS CTR DR STE 233 Field 5/27
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: FISHKILL Field 6/27
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NY Field 7/27
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 125242262 Field 8/27
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/27
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8458972097 Field 10/27
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 711 CANAL ST # 250 Field 11/27
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: STAMFORD Field 12/27
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CT Field 13/27
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 069026094 Field 14/27
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 15/27
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2035480826 Field 16/27
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: SPOSATO Field 19/27
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: ADAM Field 20/27
- The first name of the authorized official.
- Authorized Official Title or Position: OPERATIONS DIRECTOR Field 21/27
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6462081456 Field 22/27
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 1223G0001X Field 23/27
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 24/27
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 25/27
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 26/27
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 2
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
75 Holly Hill Ln
Location 1/2Greenwich, CT 06830-6098 · Phone (203) 548-0826
330 Boston Post Rd
Location 2/2Darien, CT 06820-3600 · Phone (203) 548-0826
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