SPH2 Enterprise, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9846 Issued in CT

Legal business name

SPH2 ENTERPRISE, LLC

Practice address

191 Franklin Ave
Hartford, CT 06114

Phone

(860) 296-7460

Fax

(860) 296-7459

NPI assigned

Dec 11, 2009

Organization subpart

No

Name

Ms. Diane Devries

Title

Business Manager

Phone

(860) 342-4141

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

• SPH2 Enterprise LLC

  • General Practice Dentistry
  • Meriden, CT
  • NPI 1558687103
  NPD tax ID

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

• Vipul Anant Patel, DMD

  • General Practice Dentistry
  • Portland, CT
  • NPI 1336339779
  NPD (past) GENERAL PRACTICE
• Yijung Yoon

  • General Practice Dentistry
  • Hartford, CT
  • NPI 1548947187
  NPD (past)
• Tae Chul Ho, DDS

  • General Practice Dentistry
  • Bronx, NY
  • NPI 1033306626
  NPD (past) GENERAL PRACTICE

• Care Dental Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2014.

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1245569748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 FRANKLIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06114",
            "telephone_number": "860-296-7460",
            "fax_number": "860-296-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 FRANKLIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06114",
            "telephone_number": "860-296-7460",
            "fax_number": "860-296-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPH2 ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "DEVRIES",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "860-342-4141",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT009846",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT009785",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT009920",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "9846",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002144",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002145",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002146",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Lee Spann
• Jeffrey Peter Spear, MD
• Spectrum Healthcare Hartford, LLC
• Novelette Spence, LCSW
• Mark Spencer, MD
• Timothy A Spichiger, DO
• Linda M Spiegel, APRN BC
• Joshua L Spieker, RD
• Matthew Spilka, CRNA
• Spinella Orthopaedic Associates, Inc.

• All providers in Hartford, CT
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.