Comprehensive Geriatric Dental Care LLC

Primary specialty

DentistTaxonomy code 122300000X

License

6512 Issued in CT

Legal business name

COMPREHENSIVE GERIATRIC DENTAL CARE LLC

Practice address

971 Marshall Phelps Rd
Windsor, CT 06095-2163

Phone

(860) 558-5330

NPI assigned

Dec 28, 2009

Last updated

Dec 28, 2009By 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

Gordon Holder, DDSNPI 1265480594

Title

Owner

Phone

(860) 558-5330

Specialties & licenses 1

Addresses

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.

• Gordon Orville Holder, DDS

  • General Practice Dentistry
  • Hudson, NY
  • NPI 1265480594
  Authorized official Same address or phone

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1659601557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 MARSHALL PHELPS RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952163",
            "telephone_number": "860-558-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 MARSHALL PHELPS RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952163",
            "telephone_number": "860-558-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE GERIATRIC DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-558-5330",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "6512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Windsor, CT
• Providers in Windsor, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.