Bristol Family Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010490 Issued in CT

Legal business name

BRISTOL FAMILY DENTAL, PC

Doing business as

Next Generation Dental

Practice address

4 Morris Ave
Bristol, CT 06010-4448

Phone

(860) 589-2794

Fax

(860) 314-0799

NPI assigned

May 6, 2014

Last updated

May 21, 2014By 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

Ross Katkowski, DMD

Title

President

Phone

(860) 589-2794

Specialties & licenses 1

Addresses

Other names 1

• Next Generation Dental Doing business as

Locations

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1588074025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MORRIS AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104448",
            "telephone_number": "860-589-2794",
            "fax_number": "860-314-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MORRIS AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104448",
            "telephone_number": "860-589-2794",
            "fax_number": "860-314-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "KATKOWSKI",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-589-2794",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Next Generation Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bristol Hearing AIDS, LLC
• Bristol Home Care and Hospice Agency Inc

• General Practice Dentistry in Bristol, CT
• Providers in Bristol, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.