Brenton John Lahey, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

9864 Issued in CT

Practice address

1185 Silas Deane Hwy
Wethersfield, CT 06109-4301

Phone

(860) 563-2331

NPI assigned

Mar 19, 2007

Last updated

Jan 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Connecticut Periodontal & Implant Associates

  • Periodontics
  • Windsor, CT
  • NPI 1699384966
  NPD (past)
• Fairfield Periodontics, LLC

  • Periodontics
  • Fairfield, CT
  • NPI 1508069451
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1730203035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094301",
            "telephone_number": "860-563-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094301",
            "telephone_number": "860-563-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHEY",
        "first_name": "BRENTON",
        "middle_name": "JOHN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "9864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodee Juanita Krejmas
• Rajeev A Kulkarni, D.D.S.LLC.
• Timothy Nolan Kumnick, M.ED., BCBA, LBA
• La Sala Wellness Group, PLLC
• Carla Isabel Labbe, MS, CCC-SLP
• Laurie Ridge Landry, LMFT LPC
• Sachiyo Langlois
• Erin Laprade, OTR/L
• Kristen Brooke Lathrop, PSY.D.
• Laura Gionfriddo, LLC

• Periodontics in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.