Wolcott Street Dental-1, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WOLCOTT STREET DENTAL-1, PC

Practice address

105 Myrtle Street
New Britain, CT 06051-1825

Phone

(770) 916-5028

Fax

(678) 247-7858

NPI assigned

Mar 16, 2009

Organization subpart

No

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

Authorized official

Name

Michelle Jacomino

Title

Director of Payor Relations

Phone

(770) 916-5036

Specialties & licenses 6

Addresses

Other names 1

• Sutton Dental Doing business as

Tax ID family

Sutton Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wolcott Street Dental-1, PC

  • Dentist
  • New Haven, CT
  • NPI 1568603934
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kibeom Seo, DDS

  • General Practice Dentistry
  • New Britain, CT
  • NPI 1205430816
  NPD (past)

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1013158484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-5028",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MYRTLE STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060511825",
            "telephone_number": "770-916-5028",
            "fax_number": "678-247-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLCOTT STREET DENTAL-1, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "JACOMINO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "770-916-5036"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutton Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Lee Winchester, DO
• Jonathan Winkler, M.D.
• Steve Winter, PA
• Paulina Wirkowski, PHARMD
• Jessica F Wiseman, MD
• Jacqueline Marie Wolski, RDN
• Skye Bre'Anna Womack
• Holley Marie Wood
• Donna B Woodard
• Heather Kay Woodbury, DC

• Dentist in New Britain, CT
• Providers in New Britain, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.