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Deactivated NPI 1407905094 Deactivated / Inactive NPI Male Practitioner

Dr. John Nicholas Faniola , DDS

Dentist - General Practice • Old Lyme, CT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Faniola has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 10, 2007
NPI Deactivation Date November 02, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. John Faniola, DDS was a registered Dentist - General Practice practicing in Old Lyme, CT. Throughout an active medical career spanning 15 years, Dr. Faniola provided care at the practice location at 11 ACADEMY LN until profile deactivation on 2022-11-02.

Practice Location & Contact Primary Location

Practice Address

11 Academy Ln

Old Lyme, CT 063712312

Telephone 8604342061
Fax 8604342061

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Old Lyme, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.3 Yrs
Regional Practice Density
4 Specialists

Practicing in Old Lyme, CT (1821 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CT 3992

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 02, 2022

Record deactivated on November 02, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 11 ACADEMY LN, OLD LYME, CT 063712312 (Tel: 8604342061)

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Updated Business Mailing Address July 08, 2007

Registered at 11ACADEMY LN, OLD LYME, CT 063712312 (Tel: 8604342061)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN FANIOLA, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #3992 in CT)

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Initial NPI Registration & Enumeration January 10, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407905094
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2007
Last Update: July 08, 2007
Deactivation Date: November 02, 2022

Mailing Address

11academy Ln

Old Lyme, CT 063712312

Phone: 8604342061

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.