Life Bridge Dental CT PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LIFE BRIDGE DENTAL CT PLLC

Practice address

1375 Post Rd E
Westport, CT 06880-5506

Phone

(212) 686-3686

NPI assigned

Apr 26, 2023

Organization subpart

No

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

Authorized official

Name

Neil Sullivan

Title

Director

Phone

(212) 686-3686

Specialties & licenses 1

Addresses

Other names 1

• Tend Dental Other name

Locations

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1508554700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CITY BLVD STE 204",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372092559",
            "telephone_number": "212-686-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805506",
            "telephone_number": "212-686-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BRIDGE DENTAL CT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-686-3686"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tend Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fulton Li, D. M. D.
• Adriana Liberatore, MS, RDN
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• Judith Lieberstein, PSYD
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• Dentist in Westport, CT
• Providers in Westport, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.