Dr Dental of Stratford

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010025 Issued in CT

Legal business name

DR DENTAL OF STRATFORD

Practice address

200 E Main St
Unit 13
Stratford, CT 06614-5114

Phone

(203) 378-8500

Fax

(203) 378-8501

NPI assigned

Jul 12, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Arthur Revechkis

Title

Manager

Phone

(201) 725-0372

Specialties & licenses 1

Addresses

Other names 1

• Dr. Dental Doing business as

Locations

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1124316104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "address_2": "UNIT 13",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145114",
            "telephone_number": "203-378-8500",
            "fax_number": "203-378-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "address_2": "UNIT 13",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145114",
            "telephone_number": "203-378-8500",
            "fax_number": "203-378-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DENTAL OF STRATFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "REVECHKIS",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-725-0372",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John P Donahue, MD
• Kelly Lynn Donnelly, LCSW
• Joseph C Downer Jr., LAC
• Downtown Dental Group of Stratford PC
• Stephanie Madonna Doyle, MS OTR/L
• Dr. Dental of Connecticut, PC
• Dr. Hill Educational Services LLC
• Olympia Alexandra Dreszer, ND, LAC
• Colleen Elizabeth Driscoll, PA-C
• Sean Duerr, M.D.

• General Practice Dentistry in Stratford, CT
• Providers in Stratford, 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 Jul 12, 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.