Long Ridge Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LONG RIDGE DENTAL LLC

Doing business as

Long Ridge Dental

Practice address

3741 Main St
Bridgeport, CT 06606-3609

Phone

(475) 282-4912

Fax

(475) 282-4915

NPI assigned

Jun 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Kigon Song, DDS

Title

Owner

Phone

(646) 369-6918

Specialties & licenses 3

Addresses

Other names 1

• Long Ridge Dental Doing business as

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1356756423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063609",
            "telephone_number": "475-282-4912",
            "fax_number": "475-282-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063609",
            "telephone_number": "475-282-4912",
            "fax_number": "475-282-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG RIDGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "KIGON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-369-6918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Ridge Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diane Kay Lombardi
• Sarah Noelle Lombino, RD
• Caroline Londa Arevalo
• Julie London, PA-C
• Laura London, PA-C
• Christina Lopez, LMSW
• Javier Lopez, MD
• Virginia Lopez, LCSW
• Xiomara V Lopez, LMSW
• Anne Marie Maire Lopresti, LCSW

• 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 Mar 2, 2015; 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.