ALAN D SCHUPACK DDS LLC (NPI# 1356492185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356492185 |
| Entity Type | Organization |
| Organization Name | ALAN D SCHUPACK DDS LLC |
| Other Organization Name | ALAN D SCHUPACK DDS |
| Practice Address |
850 No Main Street Extension Suite 2b Wallingford CT 06492 |
| Practice Telephone | 2032694249 |
| Practice Fax Number | 2032944444 |
| Mailing Telephone | 2032694249 |
| Mailing Fax Number | 2032944444 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ALAN DAVID SCHUPACK (MANAGER) |
| Authorized Official Telephone | 2032944444 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6675 | CT | Dental Providers |
| Other Name | Type Code |
|---|---|
| Alan D Schupack DDS | Former Legal Business Name - Organization |
| Street Address |
850 NO MAIN STREET EXTENSION SUITE 2B |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396897294 | Wendy F. Becker | Dentist | 850 No Main Street Extension, Suite 2b, Wallingford, CT 06492 | 2007-01-18 |
| 1508917337 | Alan David Schupack | Dentist | 850 No Main Street Extension, Suite 2b, Wallingford, CT 06492 | 2007-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730561952 | Renee Pamela Borecki | Dentist | 205 North Main Street, Wallingford, CT 06492 | 2015-06-24 |
| 1639405400 | Lawrence John Singer | Dentist | 33 Fair St, Wallingford, CT 06492-4208 | 2009-10-28 |
| 1467667212 | James Craig Dow | Dentist | 181 N Main St, Wallingford, CT 06492-3711 | 2007-05-14 |
| 1356564652 | Kenneth Bruce Roseman | Dentist | 826 East Center Street, Wallingford, CT 06492-5090 | 2007-04-11 |
| 1912037979 | John W Galson Jr. | Dentist | 105 N Providence Rd, Wallingford, PA 19086-6107 | 2007-03-07 |
| 1629103486 | Michael M. Greenwald | Dentist | 850 North Main St. Extension, Building 2, Suite 1-d, Wallingford, CT 06492-4214 | 2007-02-22 |
| 1043358385 | Julius Gold | Dentist | 237 Hall Ave, Wallingford, CT 06492-3573 | 2007-02-01 |
| 1477606978 | Joseph P Cheruka | Dentist | 300 Moore Rd, Wallingford, PA 19086-6844 | 2007-01-19 |
| 1477610418 | Ronald Michael Hayes | Dentist | 1 Chester Rd, Wallingford, PA 19086-6601 | 2007-01-02 |
| 1699795260 | Randy Jay Greenberg | Dentist | 150 S Turnpike Rd, Wallingford, CT 06492-4320 | 2006-07-19 |
| Find all providers in WALLINGFORD | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.