CT Braces Bridgeport Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

009802 Issued in CT

Legal business name

CT BRACES BRIDGEPORT ORTHODONTICS PC

Practice address

3909 Main St
Suite a
Bridgeport, CT 06606-2872

Phone

(203) 374-1911

Fax

(203) 683-0524

NPI assigned

Jul 16, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Shyam Desai, D.M.D

Title

Owner/Orthodontist

Phone

(203) 374-1911

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1588048748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 MAIN ST",
            "address_2": "SUITE A",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062872",
            "telephone_number": "203-374-1911",
            "fax_number": "203-683-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 MAIN ST",
            "address_2": "SUITE A",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062872",
            "telephone_number": "203-374-1911",
            "fax_number": "203-683-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT BRACES BRIDGEPORT ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_title_or_position": "OWNER/ORTHODONTIST",
        "authorized_official_telephone_number": "203-374-1911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "009802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.