Revitalizing Smiles, LLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

11048 Issued in CT

Legal business name

REVITALIZING SMILES, LLC

Practice address

2226 Black Rock Tpke
Fairfield, CT 06825-3240

Phone

(203) 332-9049

Fax

(203) 366-6287

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Judith Horblitt

Title

Manager

Phone

(203) 332-9049

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gary Edward Horblitt, MAXILLOPROSTHODONTIS

  • Prosthodontics
  • Fairfield, CT
  • NPI 1366651663
  NPD (past)

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1588058077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253240",
            "telephone_number": "203-332-9049",
            "fax_number": "203-366-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 BLACK ROCK TPKE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068253240",
            "telephone_number": "203-332-9049",
            "fax_number": "203-366-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZING SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "HORBLITT",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-332-9049"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CT",
            "license": "11048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daniel York Reuben, MD
• Daniela Reyes, OTR/L
• Jose Reyes, M.D.
• Yoberki Reyes, L.C.S.W
• Dorothy Reynolds, L.O.
• Paige Reynolds, LCSW

• Prosthodontics in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Prosthodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.