Stonington Dental Associates PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12125 Issued in CT

Legal business name

STONINGTON DENTAL ASSOCIATES PLLC

Practice address

20 S Anguilla Rd
Pawcatuck, CT 06379-1447

Phone

(860) 599-2505

NPI assigned

Apr 18, 2018

Last updated

Oct 30, 2019By 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

Ms. Amanda Kirwin

Title

Manager

Phone

(401) 578-0274

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 5

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.

• Shanthi Cariappa, DDS

  • Dentist
  • Pawcatuck, CT
  • NPI 1912318437
  NPD
• Susan Lynn Yebra, OTD

  • Occupational Therapist
  • Arlington, MA
  • NPI 1295103190
  NPD
• Scott Michael Keilty, DMD

  • General Practice Dentistry
  • Pawcatuck, CT
  • NPI 1942349576
  NPD (past)
• Eleni Milas, D.M.D.

  • General Practice Dentistry
  • Groton, CT
  • NPI 1336234608
  NPD (past)
• Jacquelyn Hadi, DMD

  • General Practice Dentistry
  • East Greenwich, RI
  • NPI 1932768876
  NPD (past)

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1043707755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S ANGUILLA RD",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S ANGUILLA RD",
            "city": "PAWCATUCK",
            "state": "CT",
            "postal_code": "063791447",
            "telephone_number": "860-599-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONINGTON DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "KIRWIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-578-0274",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "12125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristina Taylor, DC
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• Walgreen Co (Walgreens #17726)
• Crystal Rose Walsh, PHARM. D.

• Dental Clinic/Center in Pawcatuck, CT
• Providers in Pawcatuck, CT by specialty
• Dental Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.