Branford Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010878 Issued in CT

Legal business name

BRANFORD DENTAL GROUP, LLC

Practice address

1100 Barnum Ave
Stratford, CT 06614

Phone

(203) 864-3430

Fax

(203) 378-2759

NPI assigned

Feb 8, 2016

Last updated

Feb 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dharam P Tayal, DDS

Title

Owner

Phone

(203) 864-3430

Specialties & licenses 1

Addresses

Tax ID family

Branford Dental Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• East Haven Dental LLC

  • General Practice Dentistry
  • Hamden, CT
  • NPI 1164896841
  NPD tax ID

Locations

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1396103255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 WEST MAIN STREET",
            "city": "BRANDFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-864-3430",
            "fax_number": "203-378-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "06614",
            "telephone_number": "203-864-3430",
            "fax_number": "203-378-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANFORD DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "TAYAL",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-864-3430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 8, 2016; 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.