Provider Demographics
NPI:1629089651
Name:CIPES, MONICA H (DMD MSP PC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:H
Last Name:CIPES
Suffix:
Gender:F
Credentials:DMD MSP PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119
Mailing Address - Country:US
Mailing Address - Phone:860-233-1589
Mailing Address - Fax:860-233-2509
Practice Address - Street 1:798 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119
Practice Address - Country:US
Practice Address - Phone:860-233-1589
Practice Address - Fax:860-233-2509
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005611122300000X
CT56111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry