Penta Dental LC

Primary specialty

DentistTaxonomy code 122300000X

License

010878 Issued in CT

Legal business name

PENTA DENTAL LC

Practice address

1100 Barnum Ave
Stratford, CT 06614-4901

Phone

(716) 239-5889

NPI assigned

Apr 7, 2017

Organization subpart

No

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

Authorized official

Name

Dharam Tayal, DDS

Title

Member

Phone

(716) 239-5889

Specialties & licenses 1

Addresses

Other names 1

• ADMIRE DENTAL Doing business as

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1689107534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144901",
            "telephone_number": "716-239-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144901",
            "telephone_number": "716-239-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTA DENTAL LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "TAYAL",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "716-239-5889",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADMIRE DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Furino Aprn LLC
• Richard William Pecoroni, M.A.
• Pediatric Smiles LLC
• Leonardo Pena-Abosaid, D.D.S.
• Kristi Alexis Pena, OTR/L
• Diolenny Perez, LPN
• Daniel Perillo
• Personal Growth Concepts, Inc.
• Andrew J Pesale, DC
• Robert Pesale, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.