NPIMap

Organization Active NPI

Orthodontic Associates of Southeastern Connecticut, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waterford, CT
National Provider Identifier
1275734824
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
007723 Issued in CT
Legal business name
ORTHODONTIC ASSOCIATES OF SOUTHEASTERN CONNECTICUT, P.C.
Practice address
196 Parkway S
Suite 305
Waterford, CT 06385-1234
Phone
(860) 443-1827
Fax
(860) 443-1745
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory Adrian Hack, DDSNPI 1013118611
Title
Orthodontist Partner
Phone
(860) 443-1827

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 007723 CT Primary

Addresses

Primary practice location

196 Parkway S
Suite 305
Waterford, CT 06385-1234

Mailing address

196 Parkway S
Suite 305
Waterford, CT 06385-1234
Phone (860) 443-1827

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275734824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 305",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-443-1827",
            "fax_number": "860-443-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 305",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-443-1827",
            "fax_number": "860-443-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC ASSOCIATES OF SOUTHEASTERN CONNECTICUT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HACK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "ORTHODONTIST PARTNER",
        "authorized_official_telephone_number": "860-443-1827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "007723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.