NPIMap

Organization Active NPI

New Haven Dental Group

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1609916089
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEW HAVEN DENTAL GROUP
Practice address
123 York St
Suite 4L
New Haven, CT 06511-5614
Phone
(230) 781-8051
Fax
(203) 781-8089
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Authorized official

Name
Mr. Gregory Gibson
Title
Administrator
Phone
(203) 781-8051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

123 York St
Suite 4L
New Haven, CT 06511-5614

Mailing address

123 York St
Suite 4L
New Haven, CT 06511-5614
Phone (230) 781-8051

National Provider Directory

National Provider Directory
Tax ID family
New Haven Dental Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 York St
Ste 4L
New Haven, CT 06511
Phone (203) 781-8051

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1609916089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 YORK ST",
            "address_2": "SUITE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115614",
            "telephone_number": "230-781-8051",
            "fax_number": "203-781-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 YORK ST",
            "address_2": "SUITE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115614",
            "telephone_number": "230-781-8051",
            "fax_number": "203-781-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-781-8051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.