Glastonbury Family Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008288 Issued in CT

Legal business name

GLASTONBURY FAMILY DENTAL PC

Practice address

2450 Main St
Ste 1
Glastonbury, CT 06033-2041

Phone

(860) 633-6246

Fax

(860) 633-1808

NPI assigned

Dec 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey A Cohan, DMD

Title

President

Phone

(860) 633-6246

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1447596408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 MAIN ST",
            "address_2": "STE 1",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332041",
            "telephone_number": "860-633-6246",
            "fax_number": "860-633-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 MAIN ST",
            "address_2": "STE 1",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332041",
            "telephone_number": "860-633-6246",
            "fax_number": "860-633-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASTONBURY FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "COHAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-633-6246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glastonbury Dental Care
• Glastonbury Dental Group LLC
• Glastonbury Endoscopy Center, LLC
• Glastonbury Eye Care, LLC
• Glastonbury Family Dental
• Glastonbury Family Medicine LLC
• Glastonbury Health Care Center Inc
• Glastonbury Health Care Center, Inc.
• Glastonbury Naturopathic Center LLC
• Glastonbury Osteopathic, LLC

• General Practice Dentistry in Glastonbury, CT
• Providers in Glastonbury, 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 Dec 19, 2012; 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.