Avon Wellness Center Dental Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5745 Issued in CT

Legal business name

AVON WELLNESS CENTER DENTAL ASSOCIATES PC

Practice address

100 Simsbury Rd
Suite 201
Avon, CT 06001

Phone

(860) 606-0066

Fax

(860) 606-0071

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gerard Francis Graham, DDSNPI 1093857476

Title

President

Phone

(860) 606-0066

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gerard Francis Graham, DDS

  • General Practice Dentistry
  • Avon, CT
  • NPI 1093857476
  NPD (past) Authorized official

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295877678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SIMSBURY RD",
            "address_2": "SUITE 201",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-606-0066",
            "fax_number": "860-606-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SIMSBURY RD",
            "address_2": "SUITE 201",
            "city": "AVON",
            "state": "CT",
            "postal_code": "06001",
            "telephone_number": "860-606-0066",
            "fax_number": "860-606-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON WELLNESS CENTER DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-606-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avon Oral and Maxillofacial Surgery, LLP
• Avon Pediatrics, LLC
• Avon Public Schools
• Avon Simsbury Psychotherapy, LLC
• Avon Village Family Dentistry
• Radhika Naga Ayyagari, MD
• Marina Azimova
• Yvette D. Bailey, M.D.
• Henry Balavender, PT
• Makaila Baldie, APRN,PMHNP-BC

• General Practice Dentistry in Avon, CT
• Providers in Avon, CT by specialty
• General Practice Dentistry in Connecticut

• 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.