NPIMap

Organization Active NPI

Endodontic Specialists LLC

  • Endodontics
  • Ellington, CT
National Provider Identifier
1225399108
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
9473 Issued in CT
Legal business name
ENDODONTIC SPECIALISTS LLC
Practice address
2 Chucrh St # 670
Ellington, CT 06029-0670
Phone
(860) 000-0000
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Dr. Stanislav Moline, DMD, MDSNPI 1821008202
Title
Manager
Phone
(860) 000-0000

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 9473 CT Primary

Addresses

Primary practice location

2 Chucrh St # 670
Ellington, CT 06029-0670

Mailing address

PO Box 670
Ellington, CT 06029-0670

National Provider Directory

National Provider Directory

Locations

2 Church St
Unit 670
Ellington, CT 06029

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1225399108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060290670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHUCRH ST # 670",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060290670",
            "telephone_number": "860-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "MOLINE",
        "authorized_official_first_name": "STANISLAV",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-000-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CT",
            "license": "9473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.