NPIMap

Organization Active NPI

42 North Dental Care PLLC

Doing business as Southern Connecticut Dental Group - Southbury

  • Dental Clinic/Center
  • Southbury, CT
National Provider Identifier
1326692385
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL CARE PLLC
Doing business as
Southern Connecticut Dental Group - Southbury
Practice address
30 Quaker Farms Rd
Southbury, CT 06488-2732
Phone
(203) 264-4351
Fax
(203) 736-9443
NPI assigned
Jul 29, 2019
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
42 NORTH DENTAL CARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Dr. Michael A. Scialabba, DDS
Title
Chief Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

30 Quaker Farms Rd
Southbury, CT 06488-2732

Mailing address

200 5TH Ave FL 3
Waltham, MA 02451-8759
Phone (781) 647-0772

Other practice location 1

497 Main St
Ansonia, CT 06401-2333
Phone (203) 736-9443

Other names 1

  • Southern Connecticut Dental Group - Southbury Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Care PLLC8 organizations share this tax ID, including this one
Part of
42 North Dental Care PLLC

Other organizations with this tax ID 7

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

Locations

30 Quaker Farms Rd
Southbury, CT 06488
Phone (203) 262-8430

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1326692385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 5TH AVE FL 3",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518759",
            "telephone_number": "781-647-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 QUAKER FARMS RD",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882732",
            "telephone_number": "203-264-4351",
            "fax_number": "203-736-9443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 Main St",
            "address_purpose": "LOCATION",
            "city": "Ansonia",
            "state": "CT",
            "postal_code": "064012333",
            "country_code": "US",
            "telephone_number": "203-736-9443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "42 NORTH DENTAL CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL CARE PLLC",
        "enumeration_date": "2019-07-29",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Connecticut Dental Group - Southbury",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Connecticut Dental Group - Southbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.