NPIMap

Organization Active NPI

Endodontic Associates of Greater Waterbury, PC

  • Endodontics
  • Waterbury, CT
National Provider Identifier
1073638896
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
9136 Issued in CT
Legal business name
ENDODONTIC ASSOCIATES OF GREATER WATERBURY, PC
Practice address
1389 W Main St
Suite 208
Waterbury, CT 06708-3104
Phone
(203) 757-1287
Fax
(203) 575-1537
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Authorized official

Name
Dana Alliger
Title
Office Manager
Phone
(203) 757-1287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X 9136 CT Primary

Addresses

Primary practice location

1389 W Main St
Suite 208
Waterbury, CT 06708-3104

Mailing address

1389 W Main St
Suite 208
Waterbury, CT 06708-3104
Phone (203) 757-1287

National Provider Directory

National Provider Directory

Locations

1389 W Main St
Ste 208
Waterbury, CT 06708
Phone (203) 757-1113

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1073638896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 208",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-757-1287",
            "fax_number": "203-575-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 208",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-757-1287",
            "fax_number": "203-575-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES OF GREATER WATERBURY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "ALLIGER",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-757-1287"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CT",
            "license": "9136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.