Blue Back Dental LLC
NPI 1174814495ActiveOrganization· Dentist, General Practice· West Hartford, CT
Dentist, General Practice in West Hartford, Connecticut, registered in NPPES in April 2011. The authorized official on file is Kirsten E. Capozzi, Practice Manager.
Overview
| NPI | 1174814495 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 20, 2011 |
| Last updated in NPPES | Apr 20, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 5904 | CT |
| Dentist, General Practice | 1223G0001X | 8915 | CT |
| Dentist, Periodontics | 1223P0300X | 5407 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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