Charter Oak Dental Center LL LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHARTER OAK DENTAL CENTER LL LLC

Practice address

165 East Main Street
New Britain, CT 06051

Phone

(860) 224-0797

Fax

(860) 224-0799

NPI assigned

Jan 11, 2019

Organization subpart

No

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

Authorized official

Name

Angelina Blankschen

Title

Administrator

Phone

(860) 997-0569

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1619440732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 EAST MAIN STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06051",
            "telephone_number": "860-224-0797",
            "fax_number": "860-224-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 EAST MAIN STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "06051",
            "telephone_number": "860-224-0797",
            "fax_number": "860-224-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER OAK DENTAL CENTER LL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "BLANKSCHEN",
        "authorized_official_first_name": "ANGELINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-997-0569"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT DENTAL LICENSE",
            "identifier": "11063",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Chafee, PSY.D.
• Heather Lynn Champagne, PA
• Adrian Chan, M.D.
• Aviral Chandra
• Krystle Charran-Sankar, LMFT
• Jennifer Lynn Chasse
• Saleha Chaudhry, PSYD
• Eric Mario Cherry
• Shailaja Chikoti, M.B., B.S.
• Gilbert Ching, M.D.

• General Practice Dentistry in New Britain, CT
• Providers in New Britain, 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 Jan 11, 2019; 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.