CT Braces Newtown Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

CT BRACES NEWTOWN ORTHODONTICS PC

Practice address

12 Queen St
Newtown, CT 06470-2158

Phone

(203) 270-0005

Fax

(203) 683-0524

NPI assigned

Apr 13, 2018

Last updated

Apr 13, 2018By 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

Shyam Desai, DMD

Title

Owner/Orthodontist

Phone

(203) 615-3666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1609363860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 COVENTRY LN",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 QUEEN ST",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702158",
            "telephone_number": "203-270-0005",
            "fax_number": "203-683-0524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3909 Main St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066062872",
            "country_code": "US",
            "telephone_number": "203-374-1911",
            "fax_number": "203-374-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CT BRACES NEWTOWN ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_title_or_position": "OWNER/ORTHODONTIST",
        "authorized_official_telephone_number": "203-615-3666",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.