GP Dentistry Fairfield, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GP DENTISTRY FAIRFIELD, LLC

Practice address

400 Post Rd
Fairfield, CT 06824-6244

Phone

(203) 255-2493

Fax

(203) 255-9468

NPI assigned

Jun 17, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kosha Shah, DDS

Title

Owner Dentist

Phone

(650) 288-8453

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1003266362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246244",
            "telephone_number": "203-255-2493",
            "fax_number": "203-255-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 POST RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246244",
            "telephone_number": "203-255-2493",
            "fax_number": "203-255-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GP DENTISTRY FAIRFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KOSHA",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "650-288-8453",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.