Organization Active NPI

K & L Dental LLC

  • General Practice Dentistry
  • Hartford, CT
National Provider Identifier
1083955348
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009903 Issued in CT
Legal business name
K & L DENTAL LLC
Practice address
629 Albany Ave
Hartford, CT 06112-2334
Phone
(917) 669-0693
NPI assigned
Mar 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Authorized official

Name
Banghun Lee, D.D.S
Title
Owner/Dentist
Phone
(917) 669-0693

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 009903 CT Primary

Addresses

Primary practice location

629 Albany Ave
Hartford, CT 06112-2334

Mailing address

629 Albany Ave
Hartford, CT 06112-2334

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1083955348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061122334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061122334",
            "telephone_number": "917-669-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & L DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "BANGHUN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "917-669-0693",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.