KRIS KOTSAY (NPI# 1649269705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649269705 |
| Entity Type | Individual |
| Full Name | KRIS KOTSAY |
| Credential | DENTIST |
| Practice Address |
64 Black Rock Ave Bridgeport CT 06605-1200 |
| Practice Telephone | 2035795223 |
| Practice Fax Number | 2033320376 |
| Mailing Telephone | 2035795223 |
| Mailing Fax Number | 2033320376 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2012-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 009330 | CT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | STATE LICENSE | 009330 | 01 |
| Street Address |
64 BLACK ROCK AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063942555 | Keitra Thompson | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-06-15 |
| 1497283295 | Jenifer Schmitz | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605 | 2017-05-24 |
| 1093256091 | Miriam Feinstein | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-03-10 |
| 1265828818 | Theresa Integral Dy Djama | Podiatrist | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2015-04-10 |
| 1154722403 | Marlene St Juste | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-09-05 |
| 1245647486 | Lissette I Cruz | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-07-21 |
| 1891123220 | Nicole Callagy | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-10-22 |
| 1063853638 | Aswani Daraboina | Internal Medicine | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-07-11 |
| 1932479409 | Optimus Health Care Inc | Clinic/Center | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2011-12-30 |
| 1912141136 | Luz Evelyn Omondi | Internal Medicine | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2009-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225672843 | Adam M. Grubler Dds, Pllc | Dentist | 1160 Johnson Ave Ste 104, Bridgeport, WV 26330-1487 | 2019-11-06 |
| 1982149522 | Ghorbani - Mohammadi Dental P.C. | Dentist | 2676 E Main St, Columbia Dental, Bridgeport, CT 06610-1422 | 2017-01-05 |
| 1790169613 | Victor Esmeraldo | Dentist | 1808 Chico Hwy, Bridgeport, TX 76426 | 2015-07-10 |
| 1548666142 | Awesome Smiles | Dentist | 1163 E Main St, Bridgeport, CT 06608-1620 | 2014-11-08 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1891092276 | Rita Bobb-rollins, Dds, Ltd. | Dentist | 102 Tolley Dr, Bridgeport, WV 26330-1668 | 2011-02-19 |
| 1063728285 | Jeremy F Bell | Dentist | 2260 North Ave, Bridgeport, CT 06604-2413 | 2010-08-25 |
| 1093034621 | Northeast Dental Solutions LLC | Dentist | 56 Harriet St, First Floor, Bridgeport, CT 06608-2131 | 2010-05-21 |
| 1578704789 | Angelo Michael Guerrera | Dentist | 2979 Madison Ave, Bridgeport, CT 06606-2060 | 2009-03-18 |
| 1700032042 | Ezro Leviyev | Dentist | 665 Clinton Ave, Bridgeport, CT 06605-1711 | 2008-08-18 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
Please comment or provide details below to improve the information on KRIS KOTSAY.
| 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.