MR. MARK G KACERIK (NPI# 1790967784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790967784 |
| Entity Type | Individual |
| Full Name | MR. MARK G KACERIK |
| Credential | RDH |
| Practice Address |
419 Boston Post Road West Haven CT 06516 |
| Practice Telephone | 2039316029 |
| Practice Fax Number | 2039316083 |
| Mailing Telephone | 2039316029 |
| Mailing Fax Number | 2039316083 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 004980 | CT | Dental Providers |
| Street Address |
419 BOSTON POST ROAD |
| City | WEST HAVEN |
| State | CT |
| Zip Code | 06516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235452277 | Kathleen Mary Martin Lane | Dental Hygienist | 419 Boston Post Road, West Haven, CT 06516-1918 | 2010-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956421 | Thomas Lorbie Thomson IIi | Nurse Practitioner | Va Connecticut Healthcare, 950 Campbell Avenue, Mail Code: 11acsl1, Building 2b, West Haven, CT 06516 | 2020-06-12 |
| 1659911238 | Claudine Pettigrew | Social Worker | 114-52 Boston Post Road, West Haven, CT 06516 | 2020-01-10 |
| 1811531544 | Medical Center Pharmacy and Home Care Center, Inc. | Pharmacy | 600 Derby Avenue, West Haven, CT 06516 | 2019-11-06 |
| 1821649203 | Michaela Lachance | Physical Therapist | 95 Campbell Ave, West Haven, CT 06516 | 2019-09-26 |
| 1295215739 | Lisa Marie Litrenta | Social Worker | 114-152 Boston Post Rd, #2, West Haven, CT 06516 | 2018-08-15 |
| 1386121895 | Theresa Boateng | Homemaker | 150 Shingle Hill Rd, West Haven, CT 06516 | 2018-07-26 |
| 1902383458 | Bianca Gondek | Social Worker | 114-152 Boston Post Rd #2, West Haven, CT 06516 | 2018-07-26 |
| 1790279172 | Blanca L. Paccha | Nurse Practitioner | 950 Campbell Ave Bldg 2b, West Haven, CT 06516 | 2018-06-19 |
| 1184133597 | Lotus Counseling Services LLC | Counselor | 101 White St, West Haven, CT 06516 | 2017-09-28 |
| 1053867283 | Alesia Wellington | Social Worker | 114-152 Boston Post Rd, 2nd Floor, West Haven, CT 06516 | 2016-08-28 |
| Find all providers in zip 06516 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003275827 | Sandra Milena Nauzan | Dental Hygienist | 46 Clifton St, West Haven, CT 06516-2805 | 2016-02-22 |
| 1194190561 | Leeann Pastore | Dental Hygienist | 26 N Forest Cir, West Haven, CT 06516-7939 | 2015-12-09 |
| 1023666534 | Cynthia Ivette Mateo | Dental Hygienist | 16 High St, West Haven, CT 06516-2019 | 2019-08-28 |
| 1942673579 | Adriana Carolina Fields | Dental Hygienist | 419 Boston Post Rd, West Haven, CT 06516-1918 | 2015-11-04 |
| 1568835304 | Marie Rose Paulis | Dental Hygienist | 419 Boston Post Rd, West Haven, CT 06516-1918 | 2015-11-02 |
| 1235452277 | Kathleen Mary Martin Lane | Dental Hygienist | 419 Boston Post Road, West Haven, CT 06516-1918 | 2010-03-04 |
| 1639401219 | Sandra Palumbo | Dental Hygienist | 419 Boston Post Rd, West Haven, CT 06516-1918 | 2010-02-05 |
| 1447581772 | Eileen O'brien | Dental Hygienist | 419 Boston Post Rd, West Haven, CT 06516-1918 | 2010-01-27 |
| 1225218878 | Lynn Helfer | Dental Hygienist | 419 Boston Post Rd, Unh Dental Center, West Haven, CT 06516-1918 | 2007-11-13 |
| 1497935241 | Gwen Marie Grosso | Dental Hygienist | 419 Boston Post Rd, West Haven, CT 06516-1918 | 2007-11-09 |
| Find all providers in WEST HAVEN | ||||
| City | WEST HAVEN |
| Zip Code | 06516 |
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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.