Healthcare Provider Details

I. General information

NPI: 1386100949
Provider Name (Legal Business Name): SAMANTHA N. HIRT DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NEWTOWN RD STE 1A
DANBURY CT
06810-4151
US

IV. Provider business mailing address

107 NEWTOWN RD STE 1A
DANBURY CT
06810-4151
US

V. Phone/Fax

Practice location:
  • Phone: 203-994-8915
  • Fax:
Mailing address:
  • Phone: 203-994-8915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number14527
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14527
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: