Provider Demographics
NPI:1215735022
Name:NORWALK DDS LLC
Entity type:Organization
Organization Name:NORWALK DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASNIQI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-786-1132
Mailing Address - Street 1:77 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6905
Mailing Address - Country:US
Mailing Address - Phone:816-786-1132
Mailing Address - Fax:816-786-1132
Practice Address - Street 1:72 NEWTOWN AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-3025
Practice Address - Country:US
Practice Address - Phone:816-786-1132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty