NPIMap

Organization Active NPI

CT Braces, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bridgeport, CT
National Provider Identifier
1467754309
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
CT BRACES, LLC
Practice address
3741 Main St
Bridgeport, CT 06606
Phone
(203) 374-1911
NPI assigned
Nov 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Dr. Shyam Desai
Title
Manager
Phone
(203) 374-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

3741 Main St
Bridgeport, CT 06606

Mailing address

3741 Main St
Bridgeport, CT 06606-3609
Phone (203) 374-1911

Other identifiers 1

IdentifierTypeStateIssuer
1922271550MedicaidCT

Other names 1

  • Bridgeport Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CT Braces LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1467754309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063609",
            "telephone_number": "203-374-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-374-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT BRACES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-374-1911",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922271550",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

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