NPIMap

Organization Active NPI

Yankee Family Dental Care

  • General Practice Dentistry
  • West Haven, CT
National Provider Identifier
1316233182
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7148 Issued in CT
Legal business name
YANKEE FAMILY DENTAL CARE
Practice address
267 Center St
West Haven, CT 06516-4405
Phone
(203) 932-3700
Fax
(475) 238-8291
NPI assigned
Jun 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Dr. Glen Hacker, DDS
Title
Owner
Phone
(203) 932-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7148 CT Primary

Addresses

Primary practice location

267 Center St
West Haven, CT 06516-4405

Mailing address

267 Center St
West Haven, CT 06516-4405
Phone (203) 932-3700

Other identifiers 1

IdentifierTypeStateIssuer
1871668053MedicaidCT

Other names 1

  • Fairfield Dental Care Other name

National Provider Directory

National Provider Directory

Locations

267 Center St
West Haven, CT 06516
Phone (203) 932-3700

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": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1316233182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 CENTER ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164405",
            "telephone_number": "203-932-3700",
            "fax_number": "475-238-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 CENTER ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164405",
            "telephone_number": "203-932-3700",
            "fax_number": "475-238-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANKEE FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "HACKER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-932-3700",
        "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": "7148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871668053",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairfield Dental Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.