Connecticut Dental Professionals, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CONNECTICUT DENTAL PROFESSIONALS, P.C.

Practice address

410 Saybrook Rd Ste 202
Middletown, CT 06457-4777

Phone

(860) 451-5775

NPI assigned

Oct 2, 2020

Organization subpart

Yes

Parent organization

HEARTLAND DENTALAs reported in NPPES

Name

Tabatha Lemke

Title

Credentialing Coordinator

Phone

(217) 540-2100

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

• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Oxford, CT
  • NPI 1083256226
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Norwalk, CT
  • NPI 1104387489
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Milford, CT
  • NPI 1104436633
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Mansfield Center, CT
  • NPI 1447886908
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Shelton, CT
  • NPI 1689260945
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Mansfield Center, CT
  • NPI 1811508062
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • General Practice Dentistry
  • Milford, CT
  • NPI 1881225878
  NPD tax ID
• Connecticut Dental Professionals, P.C.

  • Dentist
  • Saint Louis, MO
  • NPI 1861145583
  NPD tax ID

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

• Kevin D Cross, DDS

  • General Practice Dentistry
  • Higganum, CT
  • NPI 1811989106

  General Practice

  NPD (past)
• Christopher S Gatehouse, DMD

  • Dentist
  • Clinton, CT
  • NPI 1891082616
  NPD (past)

Tax ID family

Connecticut Dental Professionals PC (9 organizations share this tax ID)

Part of

Connecticut Dental Professionals PC

Locations

• Middlesex Dental Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2020.

{
    "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"
        }
    ]
}

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• All providers in Middletown, CT
• General Practice Dentistry in Connecticut

• 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.