NPIMap

Organization Active NPI

Elite Dental Care

  • Dentist
  • Bethel, CT
National Provider Identifier
1679960280
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
010774 Issued in CT
Legal business name
ELITE DENTAL CARE
Practice address
24 Grassy Plain St
Bethel, CT 06801-1700
Phone
(203) 616-5786
NPI assigned
Apr 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Dr. Sujata Pradhan-PeckNPI 1285912410
Title
Owner
Phone
(203) 616-5786

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 010774 CT Primary

Addresses

Primary practice location

24 Grassy Plain St
Bethel, CT 06801-1700

Mailing address

24 Grassy Plain St
Bethel, CT 06801-1700
Phone (203) 616-5786

National Provider Directory

National Provider Directory

Locations

24 Grassy Plain St
Bethel, CT 06801
Phone (203) 616-5786

Practitioners & affiliated clinicians

Practitioners 1

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": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1679960280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GRASSY PLAIN ST",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011700",
            "telephone_number": "203-616-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GRASSY PLAIN ST",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011700",
            "telephone_number": "203-616-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "PRADHAN-PECK",
        "authorized_official_first_name": "SUJATA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-616-5786",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.