NPIMap

Organization Active NPI

42 North Dental Care PLLC

  • Dental Clinic/Center
  • Manchester, CT
National Provider Identifier
1447715602
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL CARE PLLC
Practice address
238 Tolland Tpke
Manchester, CT 06042-1744
Phone
(860) 327-5990
Fax
(860) 860-7912
NPI assigned
Feb 1, 2019
Organization subpart
Yes
Parent organization
42 NORTH DENTAL CARE PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Dr. Michael A. Scialabba, DDS
Title
Chief Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

238 Tolland Tpke
Manchester, CT 06042-1744

Mailing address

200 5TH Ave FL 3
Waltham, MA 02451-8759
Phone (781) 647-0772

Other names 1

  • First Line Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Care PLLC8 organizations share this tax ID, including this one
Part of
42 North Dental Care PLLC

Other organizations with this tax ID 7

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

Locations

238 Tolland Tpke
Manchester, CT 06042
Phone (860) 327-5990

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1447715602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 5TH AVE FL 3",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518759",
            "telephone_number": "781-647-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 TOLLAND TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421744",
            "telephone_number": "860-327-5990",
            "fax_number": "860-860-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "42 NORTH DENTAL CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL CARE PLLC",
        "enumeration_date": "2019-02-01",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Line Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "First Line Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.