Theologos Ted Malahias, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008564 Issued in CT

Practice address

115 Bridge St
Groton, CT 06340-3603

Phone

(860) 446-8744

NPI assigned

Jun 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridgeworks LLC

  • General Practice Dentistry
  • Groton, CT
  • NPI 1720034457
  NPD (past) Authorized official

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225230089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403603",
            "telephone_number": "860-446-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRIDGE ST",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403603",
            "telephone_number": "860-446-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAHIAS",
        "first_name": "THEOLOGOS",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc. (Pearle #C439)
• Lydia P Perry LPC Ladc
• Thomas Joseph Maciolek, PH.D.
• Jennifer Lee Mackey, D.M.D.
• Crystal Mackinnon, LCSW
• Christine M Malcom, P.T.
• John Anthony Maldonado-Rivera
• Parris Malhoit
• Mark Mammoth
• Jane Sinclair Manaras, OTR/L

• General Practice Dentistry in Groton, CT
• Providers in Groton, 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 8, 2007; 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.