NPIMap

Organization Active NPI

Renaissance Dental Group, LLC

  • General Practice Dentistry
  • Farmington, CT
National Provider Identifier
1407145204
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8050 Issued in CT
Legal business name
RENAISSANCE DENTAL GROUP, LLC
Practice address
11 South Road
Suite 210
Farmington, CT 06032
Phone
(860) 321-7715
Fax
(860) 321-7617
NPI assigned
Apr 1, 2011
Last updated
Apr 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Dr. Ruey-Jane Tsai, D.M.D.
Title
Member
Phone
(860) 321-7715

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9173 CT
General Practice Dentistry 1223G0001X 8050 CT Primary

Addresses

Primary practice location

11 South Road
Suite 210
Farmington, CT 06032

Mailing address

11 South Road
Suite 210
Farmington, CT 06032
Phone (860) 321-7715

National Provider Directory

National Provider Directory

Locations

11 South Rd
Ste 210
Farmington, CT 06032
Phone (860) 321-7715

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1407145204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SOUTH ROAD",
            "address_2": "SUITE 210",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-321-7715",
            "fax_number": "860-321-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SOUTH ROAD",
            "address_2": "SUITE 210",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "860-321-7715",
            "fax_number": "860-321-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "TSAI",
        "authorized_official_first_name": "RUEY-JANE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-321-7715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "9173",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.