NPIMap

Organization Active NPI

Myorthos Connecticut Orthodontics PC

Doing business as Orthodontic Associates of Southeastern Connecticut

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waterford, CT
National Provider Identifier
1235899816
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MYORTHOS CONNECTICUT ORTHODONTICS PC
Doing business as
Orthodontic Associates of Southeastern Connecticut
Practice address
196 Parkway South
Suite 305
Waterford, CT 06385
Phone
(860) 443-1827
NPI assigned
Dec 23, 2021
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MYORTHOS CONNECTICUT ORTHODONTICS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Casey R Lonabocker
Title
VP Operations & Strategy
Phone
(617) 535-3364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X Primary

Addresses

Primary practice location

196 Parkway South
Suite 305
Waterford, CT 06385

Mailing address

131 Dartmouth St FL 3
Boston, MA 02116-5297

Other practice location 1

96 Salem Tpke
Norwich, CT 06360-6407
Phone (860) 886-7777

Other names 1

  • Orthodontic Associates of Southeastern Connecticut Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Myorthos Connecticut Orthodontics PC5 organizations share this tax ID, including this one
Part of
Myorthos Connecticut Orthodontics PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

96 Salem Tpke
Norwich, CT 06360
Phone (860) 886-7777

Practitioners & affiliated clinicians

Practitioners 3

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": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1235899816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DARTMOUTH ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY SOUTH",
            "address_2": "SUITE 305",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "06385",
            "telephone_number": "860-443-1827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 Salem Tpke",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063606407",
            "country_code": "US",
            "telephone_number": "860-886-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYORTHOS CONNECTICUT ORTHODONTICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYORTHOS  CONNECTICUT ORTHODONTICS PC",
        "enumeration_date": "2021-12-23",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Associates of Southeastern Connecticut",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthodontic Associates of Southeastern Connecticut",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.