Connecticut Maxillofacial Surgeons, LLC
NPI 1285651133ActiveOrganization· Dentist, Oral and Maxillofacial Surgery· Farmington, CT
Dentist, Oral and Maxillofacial Surgery in Farmington, Connecticut, registered in NPPES in July 2006. The authorized official on file is Schantal Mary Thielke, RDA, Billing & Insurance Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1285651133 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 16, 2006 |
| Last updated in NPPES | Jul 21, 2025 |
| Certified by provider | Jul 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Oral and Maxillofacial Surgery Primary | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CT) |
|---|
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