Organization Active NPI

Katz Family Dental LLC

  • General Practice Dentistry
  • West Hartford, CT
National Provider Identifier
1013282698
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
005151 Issued in CT
Legal business name
KATZ FAMILY DENTAL LLC
Practice address
125 Lasalle Rd
Suite 306
West Hartford, CT 06107-2322
Phone
(860) 521-0594
Fax
(860) 521-7568
NPI assigned
Mar 15, 2012
Last updated
Mar 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Peter S Katz, DMDNPI 1043325962
Title
Owner
Phone
(860) 521-0594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 005151 CT Primary

Addresses

Primary practice location

125 Lasalle Rd
Suite 306
West Hartford, CT 06107-2322

Mailing address

125 Lasalle Rd
Suite 306
West Hartford, CT 06107-2322
Phone (860) 521-0594

Other identifiers 1

IdentifierTypeStateIssuer
20515144093MedicaidCT

National Provider Directory

National Provider Directory

Locations

125 Lasalle Rd
Ste 306
West Hartford, CT 06107
Phone (860) 521-0594

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1013282698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LASALLE RD",
            "address_2": "SUITE 306",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072322",
            "telephone_number": "860-521-0594",
            "fax_number": "860-521-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LASALLE RD",
            "address_2": "SUITE 306",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072322",
            "telephone_number": "860-521-0594",
            "fax_number": "860-521-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATZ FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-521-0594",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "005151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20515144093",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.