L&M Family Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11204 Issued in CT

Legal business name

L&M FAMILY DENTISTRY LLC

Practice address

136 Sherman Ave Ste 104
New Haven, CT 06511-5210

Phone

(475) 238-7531

NPI assigned

Dec 23, 2015

Organization subpart

No

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

Authorized official

Name

Ivan Makar

Title

Co-Owner

Phone

(475) 238-7148

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1487019121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE STE 104",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE STE 104",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115210",
            "telephone_number": "475-238-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L&M FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "MAKAR",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "475-238-7148"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Kyanko, M.D.
• Stephanie Kyc
• Marguerite Kyle
• Robert Kyle, CRNA/APRN
• Danielle D L'Heureux
• L2 Diagnostics, LLC
• Fabian Max Laage Gaupp, M.D.
• Amy Sala Labar, MD
• Kelsey Rose Labella, PA-C
• John Paul Labieniec, LCSW

• General Practice Dentistry in New Haven, CT
• Providers in New Haven, 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 23, 2015; 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.