NPIMap

Organization Active NPI

Southern Connecticut Dental Group PC

  • General Practice Dentistry
  • Ansonia, CT
National Provider Identifier
1194849356
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5880 Issued in CT
Legal business name
SOUTHERN CONNECTICUT DENTAL GROUP PC
Practice address
497 Main St
Ansonia, CT 06401-2308
Phone
(203) 735-4701
Fax
(203) 736-9443
NPI assigned
Mar 16, 2007
Last updated
May 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Dr. Ira J Stein, DDSNPI 1326269465
Title
Vice President
Phone
(203) 735-4701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5880 CT Primary

Addresses

Primary practice location

497 Main St
Ansonia, CT 06401-2308

Mailing address

497 Main St
Ansonia, CT 06401-2308
Phone (203) 735-4701

Other names 1

  • Dworkin & Stein Dental Group PC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1194849356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012308",
            "telephone_number": "203-735-4701",
            "fax_number": "203-736-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 MAIN ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012308",
            "telephone_number": "203-735-4701",
            "fax_number": "203-736-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CONNECTICUT DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "203-735-4701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dworkin & Stein Dental Group PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ansonia, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.