Dr.Dental of Bridgeport PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010025 Issued in CT

Legal business name

DR.DENTAL OF BRIDGEPORT PC

Practice address

1700 Park Ave.
Bridgeport, CT 06604-3826

Phone

(201) 725-0372

NPI assigned

Jan 21, 2014

Organization subpart

No

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

Authorized official

Name

Arthur Revechkis

Title

Managing Director

Phone

(201) 725-0372

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1306269758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PARK AVE.",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066043826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PARK AVE.",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066043826",
            "telephone_number": "201-725-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.DENTAL OF BRIDGEPORT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "REVECHKIS",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "201-725-0372"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Doxsey-McGrew, APRN-BC FNP
• Vanessa Frances Doyle, ND
• Dr Eric Katz PC
• Dr Robert Brody Personalized Natural Medicine
• Dr. Jeffrey Small
• Gail Michelle Drake, P.A.
• Dream High Dental Anesthesia, LLC
• Julianne Dreyer, M.S., CCC-SLP
• Michael Robert Droniak Jr., CRNA
• Nicholas Druar, M.D.

• General Practice Dentistry in Bridgeport, CT
• Providers in Bridgeport, 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 Jan 21, 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.