Family Dentistry of Bridgeport P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010091 Issued in CT

Legal business name

FAMILY DENTISTRY OF BRIDGEPORT P.C.

Practice address

90 Brooklawn Ave
Bridgeport, CT 06604-2010

Phone

(203) 334-4837

NPI assigned

Aug 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark Agababaev, DDS

Title

President

Phone

(718) 887-1397

Specialties & licenses 1

Addresses

Practitioners 2

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

• Tatiana Agababaeva, DMD

  • Dentist
  • Bridgeport, CT
  • NPI 1730530577
  NPD (past)
• Stanislav Gintautas, DDS

  • General Practice Dentistry
  • Stamford, CT
  • NPI 1245557644
  NPD (past)

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1124308184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BROOKLAWN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042010",
            "telephone_number": "203-334-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BROOKLAWN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042010",
            "telephone_number": "203-334-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF BRIDGEPORT P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "AGABABAEV",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-887-1397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairfield Radiation Oncology LCC
• Fairfield Sports and Spine LLC
• Olufunmilayo Olubukola Falade, MD
• Glorimar Aillyn Falcon
• Family Dental Group C.a.
• Family Foot & Ankle Specialists LLC
• Family Health and Wellness Center of Bridgeport, LLC
• Family Loving Gentle Care Home Care LLC
• Deborah X Fang, MD
• Juan G Farfan, CRNA

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, 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 23, 2011; 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.