NPIMap

Organization Active NPI

Milford Dental Specialist, P.C.

  • Dentist
  • Milford, CT
National Provider Identifier
1154745867
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
008668 Issued in CT
Legal business name
MILFORD DENTAL SPECIALIST, P.C.
Practice address
209 Boston Post Rd
Suite 312
Milford, CT 06460-3161
Phone
(203) 876-9965
Fax
(203) 876-9972
NPI assigned
Feb 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Dr. Jesus A Villegas, D.D.S
Title
Pediatric
Phone
(203) 876-9965

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 008668 CT Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

209 Boston Post Rd
Suite 312
Milford, CT 06460-3161

Mailing address

209 Boston Post Rd
Suite 312
Milford, CT 06460-3161
Phone (203) 876-9965

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1154745867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 BOSTON POST RD",
            "address_2": "SUITE 312",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603161",
            "telephone_number": "203-876-9965",
            "fax_number": "203-876-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 BOSTON POST RD",
            "address_2": "SUITE 312",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603161",
            "telephone_number": "203-876-9965",
            "fax_number": "203-876-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILFORD DENTAL SPECIALIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-17",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "VILLEGAS",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PEDIATRIC",
        "authorized_official_telephone_number": "203-876-9965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "008668",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.