Clover Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CLOVER DENTAL CARE LLC

Practice address

1209 S Broad St
Wallingford, CT 06492-1714

Phone

(203) 934-3400

NPI assigned

Jan 24, 2023

Organization subpart

No

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

Authorized official

Name

Ryan KuNPI 1437558095

Title

Member

Phone

(713) 591-5434

Specialties & licenses 1

Addresses

Practitioners 1

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

• Ryan Ku

  • Dentist
  • West Haven, CT
  • NPI 1437558095
  NPD Authorized official

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1194431056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 S BROAD ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921714",
            "telephone_number": "203-934-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 S BROAD ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921714",
            "telephone_number": "203-934-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "KU",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "713-591-5434"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collana Claxton
• John Cline, PH.D.
• Marlis Clingan, PT
• Margarida C Clouet, APRN
• Kristin Mary Clouser, PT
• Chelsea Clow
• Club Staffing
• David Anthony Clukey, D.C.
• Miriam Susan Cohen, M.D.
• Elena Colaci, OTR/L

• General Practice Dentistry in Wallingford, CT
• Providers in Wallingford, 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 Jan 30, 2023; 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.