FAIRFIELD PERIODONTICS, LLC (NPI# 1508069451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508069451 |
| Entity Type | Organization |
| Organization Name | FAIRFIELD PERIODONTICS, LLC |
| Practice Address |
71 Beach Rd Fairfield CT 06824-6001 |
| Practice Telephone | 2032557771 |
| Practice Fax Number | 2032555753 |
| Mailing Telephone | 2032557771 |
| Mailing Fax Number | 2032555753 |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CARY ALAN SHAPOFF (MANAGING PARTNER) |
| Authorized Official Telephone | 2032557771 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Street Address |
71 BEACH RD |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06824-6001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851415749 | Cary Alan Shapoff | Dentist | 71 Beach Rd, Fairfield, CT 06824-6001 | 2007-03-18 |
| 1780709097 | Perry Aaron Wasserlauf | Dentist | 71 Beach Rd, Fairfield, CT 06824-6001 | 2007-03-20 |
| 1730203035 | Brenton John Lahey | Dentist | 71 Beach Rd, Fairfield, CT 06824-6001 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
| 1831652064 | Seagull Counseling & Therapy LLC | Social Worker | 35 Nutmeg Lane, Fairfield, CT 06824 | 2019-04-14 |
| 1871018390 | Richard Matthew Carraway | Nurse Practitioner | 117 Carlynn Drive, Fairfield, CT 06824 | 2017-08-05 |
| 1811426695 | Fairfield County Health & Wellness Services II LLC | Psychiatry & Neurology | 325 Reef Road/suite 109, Fairfield, CT 06824 | 2017-06-06 |
| 1487198214 | Evamarie Koehler Elinskas | Speech-Language Pathologist | 50 Potters Lane, Fairfield, CT 06824 | 2016-12-13 |
| 1447794441 | Nicholas C Kopazna | Counselor | 433 Meadow St, Fairfield, CT 06824 | 2016-12-09 |
| 1245686997 | Tyler Wayne Vitzthum | Chiropractor | 1995 Post Rd., Fairfield, CT 06824 | 2016-05-12 |
| 1184087660 | Beth Segaloff | Social Worker | 191 Catherine Terrace, Fairfield, CT 06824 | 2016-04-01 |
| 1518342781 | April Vanbergen | Counselor | 1275 Post Rd., Suite A5, Fairfield, CT 06824 | 2015-07-29 |
| 1982089181 | Mary Cilio | Social Worker | 173 Samp Mortar Drive, Fairfield, CT 06824 | 2015-07-29 |
| Find all providers in zip 06824 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871898130 | Mark David Sutter | Dentist | 3700 Hilborn Rd Ste 300, Suite 300, Fairfield, CA 94534-7996 | 2011-01-18 |
| 1225253016 | Michael Kevin Sonick | Dentist | 1047 Old Post Rd, Fairfield, CT 06824-5906 | 2007-04-16 |
| 1851415749 | Cary Alan Shapoff | Dentist | 71 Beach Rd, Fairfield, CT 06824-6001 | 2007-03-18 |
| 1548326713 | Larry Steven Martin | Dentist | 1211 Nilles Rd, Fairfield, OH 45014-2911 | 2006-12-29 |
| 1396818142 | Valerie Margaret Godfrey | Dentist | 1225 Travis Blvd Ste H, Fairfield, CA 94533-4839 | 2006-11-16 |
| 1518401702 | Fairfield County Implants and Periodontics | Dentist | 1047 Old Post Rd, Fairfield, CT 06824-5906 | 2016-12-07 |
| 1376958520 | Rui Ma | Dentist | 1047 Old Post Rd, Fairfield, CT 06824-5906 | 2014-06-26 |
| 1447564893 | Miles Chu | Dentist | 1047 Old Post Rd, Fairfield, CT 06824-5906 | 2010-07-27 |
| 1952556797 | Fairfield County Implants & Periodontics, PC | Dentist | 1047 Old Post Rd, Fairfield, CT 06824-5906 | 2008-11-20 |
| 1205055860 | Fulton Joseph Zink | Dentist | 1525 Webster St, Suite F, Fairfield, CA 94533-4997 | 2007-04-24 |
| Find all providers in FAIRFIELD | ||||
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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.