NPIMap

Organization Active NPI

SPH Meriden LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Meriden, CT
National Provider Identifier
1013393578
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SPH MERIDEN LLC
Practice address
470 Lewis Ave
Meriden, CT 06451-2103
Phone
(203) 440-4199
NPI assigned
Aug 7, 2015
Last updated
Aug 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Authorized official

Name
Mr. Andre Lavoie
Title
Office Manager
Phone
(860) 644-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

470 Lewis Ave
Meriden, CT 06451-2103

Mailing address

470 Lewis Ave
Meriden, CT 06451-2103

National Provider Directory

National Provider Directory
Tax ID family
SPH Meriden LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1013393578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512103",
            "telephone_number": "203-440-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPH MERIDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "LAVOIE",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-644-0099",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.