Stamford Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9846 Issued in CT

Legal business name

STAMFORD PEDIATRIC DENTISTRY, LLC

Doing business as

Long Ridge Dental Group

Practice address

4 Long Ridge Rd
Stamford, CT 06905-3802

Phone

(860) 342-4141

Fax

(860) 342-1284

NPI assigned

Jul 19, 2011

Last updated

Feb 17, 2014By 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. Tae Chul Ho, DDS

Title

Owner

Phone

(860) 342-4141

Specialties & licenses 4

Addresses

Other names 1

• Long Ridge Dental Group Doing business as

Locations

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1447548805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053802",
            "telephone_number": "860-342-4141",
            "fax_number": "860-342-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053802",
            "telephone_number": "860-342-4141",
            "fax_number": "860-342-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "TAE",
        "authorized_official_middle_name": "CHUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-342-4141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "9846",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "9920",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "009846",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "009846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Ridge Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Stamford, CT
• Providers in Stamford, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; 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.