The Dentist LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

020004762CT01 Issued in CT

Legal business name

THE DENTIST LLC

Practice address

2434 Berlin Tpke
Newington, CT 06111-4121

Phone

(860) 667-8186

Fax

(860) 667-8179

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Pam Kennedy, MS

Title

Office Manager

Phone

(860) 667-8186

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Robert A. Kennedy, DDS

  • General Practice Dentistry
  • Newington, CT
  • NPI 1194933721
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043428683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 BERLIN TPKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061114121",
            "telephone_number": "860-667-8186",
            "fax_number": "860-667-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 BERLIN TPKE",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061114121",
            "telephone_number": "860-667-8186",
            "fax_number": "860-667-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-667-8186",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "020004762CT01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Newington, CT
• Providers in Newington, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.