NPIMap

Organization Active NPI

Dental Group of Meriden-Wallingford

  • Pediatric Dentistry
  • Meriden, CT
National Provider Identifier
1235369794
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7806 Issued in CT
Legal business name
DENTAL GROUP OF MERIDEN-WALLINGFORD
Practice address
298 Broad St
Meriden, CT 06450-5853
Phone
(203) 235-5588
Fax
(203) 630-3021
NPI assigned
Jul 19, 2009
Last updated
Jan 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Dr. Sunita Kalluri
Title
President/Owner
Phone
(203) 235-5588

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4108 CT
Pediatric Dentistry 1223P0221X 7806 CT Primary

Addresses

Primary practice location

298 Broad St
Meriden, CT 06450-5853

Mailing address

298 Broad St
Meriden, CT 06450-5853
Phone (203) 235-5588

National Provider Directory

National Provider Directory

Locations

298 Broad St
Meriden, CT 06450
Phone (203) 235-5588

Practitioners & affiliated clinicians

Practitioners 5

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": "1247961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1235369794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505853",
            "telephone_number": "203-235-5588",
            "fax_number": "203-630-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 BROAD ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064505853",
            "telephone_number": "203-235-5588",
            "fax_number": "203-630-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL GROUP OF MERIDEN-WALLINGFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-19",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "KALLURI",
        "authorized_official_first_name": "SUNITA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "203-235-5588",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4108",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "7806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.