Organization Active NPI

Hebron Family Dentist PLLC

  • General Practice Dentistry
  • Hebron, CT
National Provider Identifier
1659250058
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HEBRON FAMILY DENTIST PLLC
Practice address
107 Main St
Hebron, CT 06248-1519
Phone
(203) 685-8193
NPI assigned
Aug 29, 2025
Last updated
Aug 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Authorized official

Name
Nahal Bakhtiari, DDSNPI 1558541730
Title
Dentist
Phone
(203) 685-8193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

107 Main St
Hebron, CT 06248-1519

Mailing address

107 Main St
Hebron, CT 06248-1519
Phone (203) 685-8193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251002001326 CT Part B Supplier - Clinic/Group Practice 3577069160 Receives reassigned benefits from 1 practitioner
Practice locations: Hebron, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756425600000",
    "number": "1659250058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MAIN ST",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481519",
            "telephone_number": "203-685-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAIN ST",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481519",
            "telephone_number": "203-685-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBRON FAMILY DENTIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A",
        "authorized_official_last_name": "BAKHTIARI",
        "authorized_official_first_name": "NAHAL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "203-685-8193",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hebron, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.