Sophia Diana Beason-Brown, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

009594 Issued in CT

Practice address

381 Hopmeadow St, Suite 301
Weatogue, CT 06089

Phone

(860) 232-9002

NPI assigned

Mar 19, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Windsor Implant & Cosmetic Dentistry

  • General Practice Dentistry
  • Windsor, CT
  • NPI 1730917576
  NPD Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689798068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 ALBANY AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172302",
            "telephone_number": "860-308-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 HOPMEADOW ST, SUITE 301",
            "city": "WEATOGUE",
            "state": "CT",
            "postal_code": "06089",
            "telephone_number": "860-232-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASON-BROWN",
        "first_name": "SOPHIA",
        "middle_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009594",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Ganeles MD LLC
• Rachael Balboni
• Richard H Bason, MD
• Kim Lee Bergeron-Duncan, O.D.
• Bethel Health Management Associates, Inc.
• Marc Bonaguide, LCSW
• Matthew Burns, PA-C
• Matthew Chere, DC

• General Practice Dentistry in Weatogue, CT
• Providers in Weatogue, 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 Mar 7, 2023; 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.