Ridgefield Oral and Maxillofacial Surgery, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

RIDGEFIELD ORAL AND MAXILLOFACIAL SURGERY, LLC

Practice address

10 South St Ste 202
Ridgefield, CT 06877-4125

Phone

(203) 403-3686

NPI assigned

Mar 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Steven Edward Smullin, DMD, MDNPI 1679554513

Title

Owner

Phone

(203) 403-3686

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Steven Edward Smullin, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Ridgefield, CT
  • NPI 1679554513
  NPD (past) Authorized official

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1083173538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 BROOKHOLLOW LN",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021014",
            "telephone_number": "617-230-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SOUTH ST STE 202",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774125",
            "telephone_number": "203-403-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEFIELD ORAL AND MAXILLOFACIAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "SMULLIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-403-3686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@ridgefieldoralsurgery.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "10 South St Ste 202",
            "city": "Ridgefield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068774125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ridgefield Eyecare,Inc.
• Ridgefield Family Eye Care PC
• Ridgefield Ophthalmology, LLC
• Ridgefield Pediatric Associates
• Ridgefield Physical Therapy LLC
• Ridgefield Public Schools
• Ridgefield Sensory Clinic LLC
• Ridgefield Sports Medicine, LLC

• Oral and Maxillofacial Surgery (Dentist) in Ridgefield, CT
• Providers in Ridgefield, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.