Wolcott Street Dental-2, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WOLCOTT STREET DENTAL-2, PC

Doing business as

Sutton Dental

Practice address

144 Boston Ave
Bridgeport, CT 06610-1604

Phone

(800) 920-9947

Fax

(678) 904-5666

NPI assigned

Aug 31, 2009

Organization subpart

No

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

Authorized official

Name

Michelle Jacomino

Title

Director of Payor Relations

Phone

(770) 916-5036

Specialties & licenses 6

Addresses

Other names 1

• Sutton Dental Doing business as

Tax ID family

Sutton Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Wolcott Street Dental-2, PC

  • Dentist
  • Waterbury, CT
  • NPI 1134359623
  NPD tax ID
• Wolcott Street Dental-2, PC

  • Dentist
  • Hartford, CT
  • NPI 1477878973
  NPD tax ID

Practitioners 1

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

• Saima A Khan, DDS

  • Pediatric Dentistry
  • Bridgeport, CT
  • NPI 1730316597

  General Practice

  NPD (past)

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1538392170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BOSTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101604",
            "telephone_number": "800-920-9947",
            "fax_number": "678-904-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLCOTT STREET DENTAL-2, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "JACOMINO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "770-916-5036"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutton Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ernest A. Winhoffer, D.D.S.
• Vikki A. Winks
• Sarah E Winter, PA-C
• Richard L. Wintermute, M.D.
• Marie Christine Winters, ND
• Linda D Wolf, MD
• Armand John Wolff, MD
• Women'S Medical Group, P.C.
• Henry Wong
• Dylan Jay Wood

• Dentist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.