Greater Waterbury Oral & Maxillofacial Surgeons LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

GREATER WATERBURY ORAL & MAXILLOFACIAL SURGEONS LLC

Practice address

1389 W Main St
Suite 320
Waterbury, CT 06708-3104

Phone

(203) 573-1427

Fax

(203) 574-2460

NPI assigned

Jul 16, 2006

Last updated

Apr 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John J Hillgen, D.M.D.NPI 1538193370

Title

Owner

Phone

(203) 573-1427

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

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.

• John Joseph Hillgen IV, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Waterbury, CT
  • NPI 1538193370
  Medicare reassignment NPD Authorized official
• Andrew F. Keene, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Waterbury, CT
  • NPI 1508951468
  NPD (past)
• Susan J Sherman, MSW, LCSW

  • Clinical Social Worker
  • Naugatuck, CT
  • NPI 1174802094
  NPD (past)
• Steven W Carney, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Bronx, NY
  • NPI 1114183365
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1033136825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 320",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-573-1427",
            "fax_number": "203-574-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 320",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-573-1427",
            "fax_number": "203-574-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER WATERBURY ORAL & MAXILLOFACIAL SURGEONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "HILLGEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-573-1427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Granieri, D.O.
• Nickeshia Grant
• Nicole Grant
• Dori Grasso
• Greater Waterbury Imaging Center Limited Partnership
• Emily Greco
• Peter C Greco, MD
• Monica Green-Connell, MSPT CSCS
• Amanda Green
• Maria Paleologos Green, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.