Avon Village Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

AVON VILLAGE FAMILY DENTISTRY

Practice address

32 East Main Street
Avon, CT 06001-1039

Phone

(860) 678-1140

Fax

(860) 284-4423

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Lauren M Mentasti, DMDNPI 1225265259

Title

Owner

Phone

(860) 678-1140

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Avon Village Family Dentistry Former legal business name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 5

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

• Lauren Mentasti, DMD, MPH

  • General Practice Dentistry
  • Avon, CT
  • NPI 1225265259
  NPD Authorized official
• Priya Anne John, DMD

  • General Practice Dentistry
  • Avon, CT
  • NPI 1588234595
  NPD (past)
• Nicolas Mesloh, DMD

  • General Practice Dentistry
  • Avon, CT
  • NPI 1518658293
  NPD (past)
• Ann Marion Sagalyn, DMD

  • Dentist
  • Avon, CT
  • NPI 1720236706
  NPD (past)
• Samantha Weston

  • General Practice Dentistry
  • Avon, CT
  • NPI 1528419215
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1376663609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 EAST MAIN STREET",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060011039",
            "telephone_number": "860-678-1140",
            "fax_number": "860-284-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 EAST MAIN STREET",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060011039",
            "telephone_number": "860-678-1140",
            "fax_number": "860-284-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON VILLAGE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MENTASTI",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-678-1140",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7587810001",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avon Village Family Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Avon Medical Professionals, LLC
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• Avon Pediatrics, LLC
• Avon Public Schools
• Avon Simsbury Psychotherapy, LLC
• Avon Wellness Center Dental Associates PC
• Radhika Naga Ayyagari, MD
• Marina Azimova
• Yvette D. Bailey, M.D.
• Henry Balavender, PT

• General Practice Dentistry in Avon, CT
• Providers in Avon, 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 Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.