DR. CRAIG ALLEN STASULIS (NPI# 1649464991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649464991 |
| Entity Type | Individual |
| Full Name | DR. CRAIG ALLEN STASULIS |
| Credential | D.M.D., M.D. |
| Practice Address |
435 Willard Ave Unit D Newington CT 06111-2318 |
| Practice Telephone | 8607961329 |
| Mailing Telephone | 8607961329 |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2019-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
009948 | CT | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 48060 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
435 WILLARD AVE UNIT D |
| City | NEWINGTON |
| State | CT |
| Zip Code | 06111-2318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881237402 | Craig A. Stasulis Dmd, Md, Oral and Maxillofacial Surgery, Inc | Dentist | 435 Willard Ave Unit D, Newington, CT 06111-2318 | 2019-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952880056 | Insight To Wellness Therapeutic Services, LLC | Community/Behavioral Health | 66 Cedar St. Suite 201, Newington, CT 06111 | 2018-08-09 |
| 1356843833 | Myeyedr Optometry of Connecticut, LLC | Optometrist | 38 Fenn Road, Newington, CT 06111 | 2018-03-01 |
| 1942719927 | Jessica Quintero-villa | Chiropractor | Judson Family Chiropractic, 133 Louis St., Newington, CT 06111 | 2017-09-22 |
| 1194245993 | Serrita Roper | Registered Nurse | 11 Edward St, Newington, CT 06111 | 2017-06-22 |
| 1417482522 | Aditi Thakkar | Student in an Organized Health Care Education/Training Program | 555 Willard Avenue, Newington Va Hospital, Newington, CT 06111 | 2017-04-26 |
| 1033562525 | Hassan Bin Attique | Student in an Organized Health Care Education/Training Program | Newington Va Hospital, Newington Vamc, Firm Chief, Firm 2, Vact Primary Care, Newington, CT 06111 | 2016-07-19 |
| 1013360098 | Home Care Associates of Ct 2 Inc | In Home Supportive Care | 66 Cedar Street, Unit 301, Newington, CT 06111 | 2016-07-14 |
| 1548623259 | Aniket Sharma | Student in an Organized Health Care Education/Training Program | Newington Va Hospital, 555 Willard Avenue, Newington Vamc, Firm Chief, Firm 2, Vact Pri, Newington, CT 06111 | 2016-03-30 |
| 1790104883 | Patrick Ogurick | Pediatrics | 141 Willard Avenue, Newington, CT 06111 | 2014-04-16 |
| 1922438217 | Susan Pollock May | Dentist | 51 Market Sq., Newington, CT 06111 | 2013-11-22 |
| Find all providers in zip 06111 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730411372 | Robert A Rossetti | Oral & Maxillofacial Surgery | 76 Palomba Drive, Enfield, CT 06082 | 2010-02-08 |
| 1992916787 | Associated Oral and Maxillofacial Surgeons | Oral & Maxillofacial Surgery | 107 Newtown Rd., Suite 1a, Danbury, CT 06810 | 2007-05-24 |
| 1699890723 | Philip Flemming Pacelli IIi | Oral & Maxillofacial Surgery | 166 Cherry Street, Suite A, New Canaan, CT 06840 | 2007-03-20 |
| 1497838056 | Steven Reiner | Oral & Maxillofacial Surgery | 80 S Main Street, Middletown, CT 06457 | 2006-10-24 |
| 1982616074 | Louis Vincent Theodos | Oral & Maxillofacial Surgery | 52 Federal Rd Ste 2a, Danbury, CT 06810-6162 | 2006-08-13 |
| 1326062738 | Roger A Lowlicht | Oral & Maxillofacial Surgery | 185 Maple Ave, North Haven, CT 06473 | 2006-07-27 |
| 1447202593 | Robert A Rossetti Dmd Md PC | Oral & Maxillofacial Surgery | 76 Palamba Drive, Enfield, CT 06082 | 2006-05-17 |
| 1629038062 | John R Kashmanian Dmd PC | Oral & Maxillofacial Surgery | 15 A Searles Rd, Pomfret Center, CT 06259 | 2006-03-27 |
| 1578540043 | Ralph Szilagyi | Oral & Maxillofacial Surgery | 25 Weston Rd, Westport, CT 06880 | 2005-12-27 |
| 1336133446 | Richard J Martin | Oral & Maxillofacial Surgery | 159 Sachem St, Norwich, CT 06360-4144 | 2005-09-02 |
| Find all providers with the same taxonomy | ||||
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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.