Periodontal Associates, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

9008 Issued in CT

Legal business name

PERIODONTAL ASSOCIATES, LLC

Practice address

61 4TH St
Stamford, CT 06905-5010

Phone

(203) 323-5900

NPI assigned

May 29, 2005

Last updated

Aug 22, 2020By 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

Dr. Robert Chung, DDS

Title

Member

Phone

(203) 323-5900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1117324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558364091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 4TH ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055010",
            "telephone_number": "203-323-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 4TH ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055010",
            "telephone_number": "203-323-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-323-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "9008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Perell
• Jazzeline Nicole Perez, DPT
• Performance Physical Therapy of CT (performance Physical Therapy)
• Performance Physical Therapy of Stamford LLC (Performance Physical Therapy of Stamford)
• Peter M Perimenis, DDS
• Cindy Perjon, LCSW
• Sherry Perlstein, MSW
• Robert V Pernice, LCSW
• Christopher Perry, M.S., L.AC.
• Cleveland Stanford Perry, D.D.S

• Periodontics in Stamford, CT
• Providers in Stamford, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.