NPIMap

Organization Active NPI

Brookfieldfamilydentalart

  • Dentist
  • Brookfield, CT
National Provider Identifier
1366649188
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9194 Issued in CT
Legal business name
BROOKFIELDFAMILYDENTALART
Practice address
2 Old New Milford Road
Suite 3 a
Brookfield, CT 06804
Phone
(203) 740-1014
Fax
(203) 740-1016
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Dr. Rawa Hassan, DDSNPI 1598865867
Title
Doctor
Phone
(203) 740-1014

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 9194 CT Primary

Addresses

Primary practice location

2 Old New Milford Road
Suite 3 a
Brookfield, CT 06804

Mailing address

2 Old New Milford Road
Suite 3 a
Brookfield, CT 06804
Phone (203) 740-1014

National Provider Directory

National Provider Directory

Locations

2 Old New Milford Rd
Ste 3A
Brookfield, CT 06804
Phone (203) 740-1014

Practitioners & affiliated clinicians

Practitioners 1

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": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1366649188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD ROAD",
            "address_2": "SUITE 3 A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "06804",
            "telephone_number": "203-740-1014",
            "fax_number": "203-740-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD ROAD",
            "address_2": "SUITE 3 A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "06804",
            "telephone_number": "203-740-1014",
            "fax_number": "203-740-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKFIELDFAMILYDENTALART",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "RAWA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "203-740-1014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "9194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.