Family Dental Practice of Bloomfield

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTAL PRACTICE OF BLOOMFIELD

Practice address

3 Northwestern Dr
Bloomfield, CT 06002-3465

Phone

(860) 242-5594

NPI assigned

Apr 3, 2007

Last updated

Aug 22, 2020By 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

Heidi B Tiedmann

Title

Dental Administrator

Phone

(860) 242-5594

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Jonathan Eric Mason, D.M.D.

  • General Practice Dentistry
  • Bloomfield, CT
  • NPI 1255452660
  NPD (past)
• Stephen H Mason, D.M.D.

  • General Practice Dentistry
  • Bloomfield, CT
  • NPI 1154440071
  NPD (past)
• Jeffrey R. Morris

  • General Practice Dentistry
  • Bloomfield, CT
  • NPI 1366561201
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114048519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-242-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-242-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL PRACTICE OF BLOOMFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIEDMANN",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTAL ADMINISTRATOR",
        "authorized_official_telephone_number": "860-242-5594"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellis Medical Center, LLC
• Cheryl Ellis, PSYD
• Erin & Holly II LLC (Comfort Keepers)
• Elizabeth Yvonne Evans, M.D.
• Lynn Fairchild, PA
• Family Life Lifters, Inc.
• Family Optometric Care PC
• Julie Jason Farrelly
• Maureen Elizabeth Fearon, APRN
• David Allen Feingold, MD

• General Practice Dentistry in Bloomfield, CT
• Providers in Bloomfield, 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 Aug 22, 2020; 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.