Orange Center Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ORANGE CENTER DENTISTRY PC

Doing business as

Grassy Hill Dentistry

Practice address

676 New Haven Ave
Suite a-3
Derby, CT 06418-2500

Phone

(475) 777-5108

Fax

(475) 777-5118

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Christopher C. Cogguillo, DDS

Title

President

Phone

(475) 777-5108

Specialties & licenses 1

Addresses

Other names 1

• Grassy Hill Dentistry Doing business as

Locations

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1053795070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 NEW HAVEN AVE",
            "address_2": "SUITE A-3",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182500",
            "telephone_number": "475-777-5108",
            "fax_number": "475-777-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 NEW HAVEN AVE",
            "address_2": "SUITE A-3",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182500",
            "telephone_number": "475-777-5108",
            "fax_number": "475-777-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE CENTER DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "COGGUILLO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "475-777-5108",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grassy Hill Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adambeke Nwozuzu, MD
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• Jimin Oh, D.D.S
• Omowumi Funmilola Olarinmoye, MD
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• Erin E Ostberg, LCSW
• Srihari Paidakula, M.D.
• Vivek Pandav, MD
• Jea Young Park

• General Practice Dentistry in Derby, CT
• Providers in Derby, 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 Jul 20, 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.