DR. JOSEPH STATKEVICH (NPI# 1043366354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043366354 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH STATKEVICH |
| Credential | D.M.D. |
| Practice Address |
80 Phoenix Ave Suite 202 Waterbury CT 06702-1418 |
| Mailing Address |
71 Bridlepath Dr Southington CT 06489-4043 |
| Practice Telephone | 2035743343 |
| Practice Fax Number | 2035745488 |
| Mailing Telephone | 8606286677 |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
007734 | CT | Dental Providers |
| Street Address |
80 PHOENIX AVE SUITE 202 |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702-1418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497756902 | Michael Bass | Dentist | 80 Phoenix Ave, Suite #102, Waterbury, CT 06702-1418 | 2005-08-09 |
| 1356996920 | Raeven B Keene | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-08-09 |
| 1578022166 | Daedly Potusek | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-03-14 |
| 1598239873 | Ashley Corso | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2019-01-19 |
| 1326510801 | Monica Rose Depaolo | Dental Hygienist | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2018-12-21 |
| 1023536232 | Courtney Dowen | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2017-09-07 |
| 1851834147 | Lindsey Maloney | Nurse Practitioner | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2016-11-18 |
| 1063864346 | Miguel Mantilla | Internal Medicine | 80 Phoenix Ave, Waterbury, CT 06702-1418 | 2016-07-11 |
| 1124477518 | George Gogas | Social Worker | 80 Phoenix Ave, Suite 201, Waterbury, CT 06702-1418 | 2016-06-07 |
| 1649626300 | Irene Maturo | Dental Hygienist | 80 Phoenix Ave, Suite 201, Waterbury, CT 06702-1418 | 2016-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
| 1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
| 1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
| 1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
| 1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
| 1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
| 1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
| 1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
| 1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
| Find all providers in zip 06702 | ||||
| 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 |
|---|---|---|---|---|
| 1831758754 | Ivette Lora | Dentist | 3670 E Main St Ste 10, Waterbury, CT 06705-3871 | 2019-06-13 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1093161234 | Smile and Shine Dental, LLC | Dentist | 158 Manor Avenue, Waterbury, CT 06705-1206 | 2016-05-06 |
| 1639550577 | Barbara Anne Graham | Dentist | 738 Wolcott St, Waterbury, CT 06705-1336 | 2015-06-16 |
| 1528403177 | Daniel G. Brennan | Dentist | 2457 East Main St, Waterbury, CT 06705 | 2013-05-08 |
| 1255670816 | Lon Polverari | Dentist | 835 Wolcott St, Waterbury, CT 06705-1315 | 2013-02-01 |
| 1568700920 | Brass City Dentistry | Dentist | 3670 E Main St, Suite 10, Waterbury, CT 06705-3851 | 2013-01-19 |
| 1821344532 | Sumit Sehgal | Dentist | 133 Scovill St Ste 213, Waterbury, CT 06706-1127 | 2012-07-31 |
| 1346559499 | Roman Shamuelov | Dentist | 1127 West Main Street, Waterbury, CT 06708 | 2010-10-06 |
| Find all providers in WATERBURY | ||||
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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.