NPIMap

Organization Active NPI

Connecticut Dental Professionals, P.C.

Doing business as Middlesex Dental Care

  • General Practice Dentistry
  • Middletown, CT
National Provider Identifier
1326645334
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Doing business as
Middlesex Dental Care
Practice address
410 Saybrook Rd Ste 202
Middletown, CT 06457-4777
Phone
(860) 451-5775
NPI assigned
Oct 2, 2020
Last updated
Oct 2, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

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

Addresses

Primary practice location

410 Saybrook Rd Ste 202
Middletown, CT 06457-4777

Mailing address

410 Saybrook Rd Ste 202
Middletown, CT 06457-4777

Other names 1

  • Middlesex Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Dental Professionals PC9 organizations share this tax ID, including this one
Part of
Connecticut Dental Professionals PC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

440 Saybrook Rd
Ste 1
Middletown, CT 06457
Phone (860) 346-3443

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1326645334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 202",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 202",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574777",
            "telephone_number": "860-451-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesex Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.