NPIMap

Organization Active NPI

Connecticut Dental Groups

Doing business as Groton Dental Group

  • General Practice Dentistry
  • Groton, CT
National Provider Identifier
1457420770
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CONNECTICUT DENTAL GROUPS
Doing business as
Groton Dental Group
Practice address
1100 Poquonnock Rd
Groton, CT 06340
Phone
(860) 445-9765
Fax
(860) 445-2757
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Nicolina Soucy
Title
General Manager
Phone
(860) 456-3153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1100 Poquonnock Rd
Groton, CT 06340

Mailing address

1100 Poquonnock Rd
Groton, CT 06340
Phone (860) 445-9765

Other names 1

  • Groton Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Dental Groups2 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.

Locations

1100 Poquonnock Rd
Groton, CT 06340
Phone (860) 421-9936

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457420770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-9765",
            "fax_number": "860-445-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-9765",
            "fax_number": "860-445-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT DENTAL GROUPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOUCY",
        "authorized_official_first_name": "NICOLINA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "860-456-3153",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Groton Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.