NPIMap

Organization Active NPI

42 North Dental Care PLLC

Doing business as Groton Dental Group

  • Dental Clinic/Center
  • Groton, CT
National Provider Identifier
1033708656
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL CARE PLLC
Doing business as
Groton Dental Group
Practice address
1100 Poquonnock Rd
Groton, CT 06340-4209
Phone
(860) 445-9765
NPI assigned
Jan 18, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
42 NORTH DENTAL CARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Dr. Michael Angelo Scialabba, DDS
Title
Chief Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1100 Poquonnock Rd
Groton, CT 06340-4209

Mailing address

200 5TH Ave FL 3
Waltham, MA 02451-8759
Phone (781) 647-0772

Other names 1

  • Groton Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Care PLLC8 organizations share this tax ID, including this one
Part of
42 North Dental Care PLLC

Other organizations with this tax ID 7

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

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": "1610928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1033708656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 5TH AVE FL 3",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518759",
            "telephone_number": "781-647-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404209",
            "telephone_number": "860-445-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "42 NORTH DENTAL CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL CARE PLLC",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANGELO",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Groton Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Groton Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.