Modern Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MODERN FAMILY DENTAL

Practice address

360 Boston Ave
Suite 17
Stratford, CT 06614-5213

Phone

(860) 437-3462

Fax

(860) 437-3485

NPI assigned

Feb 6, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Mrowka

Title

Office Manager

Phone

(860) 437-3462

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SGroup LLC Other name

Locations

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1386035707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BOSTON AVE",
            "address_2": "SUITE 17",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145213",
            "telephone_number": "860-437-3462",
            "fax_number": "860-437-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BOSTON AVE",
            "address_2": "SUITE 17",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145213",
            "telephone_number": "860-437-3462",
            "fax_number": "860-437-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "MROWKA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-437-3462",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386035707",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942579768",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SGroup LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Suha H Mishalani, M.D.
• Aleksandra Misiewicz
• Cristal Mitchell
• John P. Mitchell, RPH
• Navnit S. Mitter, MSC, MS, PHD
• Mogelof Dental Group, LLC
• Andrew Mogelof, DDS
• Scott Aaron Mogelof, DMD
• Susan K. Monk, LPC
• Carla M Monteiro, D.M.D.

• General Practice Dentistry in Stratford, CT
• Providers in Stratford, 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 Sep 21, 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.