Connecticut East Dental Center, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CONNECTICUT EAST DENTAL CENTER, LLC

Practice address

281 Hartford Tpke Ste 210
Vernon, CT 06066-4759

Phone

(860) 875-5989

NPI assigned

Mar 6, 2025

Last updated

Mar 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barbara J Khan

Title

Business Manager

Phone

(860) 875-5989

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1497553150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE STE 210",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664759",
            "telephone_number": "860-875-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 HARTFORD TPKE STE 210",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664759",
            "telephone_number": "860-875-5989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120A Main St",
            "address_purpose": "LOCATION",
            "city": "Willimantic",
            "state": "CT",
            "postal_code": "062262014",
            "country_code": "US",
            "telephone_number": "860-423-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONNECTICUT EAST DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "860-875-5989"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.