Fairfield Oral Surgery, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

9276 Issued in CT

Legal business name

FAIRFIELD ORAL SURGERY, LLC

Practice address

1305 Post Rd
Suite 303
Fairfield, CT 06824-6016

Phone

(203) 259-2227

Fax

(203) 259-2218

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Todd Evan Bloom, M.S., D.D.S.NPI 1972559391

Title

President

Phone

(203) 259-2227

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Todd Evan Bloom, M.S., D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fairfield, CT
  • NPI 1972559391
  NPD (past) Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1487692174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 POST RD",
            "address_2": "SUITE 303",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246016",
            "telephone_number": "203-259-2227",
            "fax_number": "203-259-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 POST RD",
            "address_2": "SUITE 303",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246016",
            "telephone_number": "203-259-2227",
            "fax_number": "203-259-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD ORAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-259-2227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.S., D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "9276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairfield Interventional and Vascular Specialists PC
• Fairfield Medical Group, LLC
• Fairfield Neuropsychology LLC
• Fairfield Ophthalmology, LLC
• Fairfield Optical, Inc.
• Fairfield Pediatric Speech Therapy
• Fairfield Pediatrics Inc
• Fairfield Periodontics, LLC
• Fairfield Plastic Surgery, LLC
• Fairfield Podiatry Associates LLC

• Dental Clinic/Center in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Dental Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.