=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679424485
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JARRETT ORTHODONTIC GROUP PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2026
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24 OLD KINGS HWY S
-----------------------------------------------------
City | DARIEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06820-4550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-655-4007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 PACIFIC ST APT 412
-----------------------------------------------------
City | STAMFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06902-7594
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-240-1537
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | DR. DANIEL JARRETT
-----------------------------------------------------
Credential | DMD, MS
-----------------------------------------------------
Telephone | 612-240-1537
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------