D'Agostino Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

006504 Issued in CT

Legal business name

D'AGOSTINO FAMILY DENTAL, LLC

Practice address

21 Washington Ave
Suite D
North Haven, CT 06473-2310

Phone

(203) 239-2050

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Vincent D'Agostino, D.M.D.

Title

Owner

Phone

(203) 239-2050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1295877199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WASHINGTON AVE",
            "address_2": "SUITE D",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732310",
            "telephone_number": "203-239-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WASHINGTON AVE",
            "address_2": "SUITE D",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732310",
            "telephone_number": "203-239-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D'AGOSTINO FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-239-2050",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "006504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.