Healthcare Provider Details

I. General information

NPI: 1104561059
Provider Name (Legal Business Name): JOSEPH NOORY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 JOSIES RING RD
MONROE CT
06468-1471
US

IV. Provider business mailing address

97 JOSIES RING RD
MONROE CT
06468-1471
US

V. Phone/Fax

Practice location:
  • Phone: 203-581-0808
  • Fax:
Mailing address:
  • Phone: 203-581-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number14711
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: