NPIMap

Organization Active NPI

Uconn Health Center

  • Oral and Maxillofacial Radiology Dentistry
  • Farmington, CT
National Provider Identifier
1770572588
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
004751 Issued in CT
Legal business name
UCONN HEALTH CENTER
Practice address
263 Farmington Ave
Oral and Maxillofacial Radiology MC 2110
Farmington, CT 06030-0001
Phone
(860) 679-2453
Fax
(860) 679-2756
NPI assigned
Oct 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alan G. Lurie, DDS
Title
Professor
Phone
(860) 679-2453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0008X 004751 CT Primary

Addresses

Primary practice location

263 Farmington Ave
Oral and Maxillofacial Radiology MC 2110
Farmington, CT 06030-0001

Mailing address

263 Farmington Ave
Oral and Maxillofacial Radiology MC 2110
Farmington, CT 06030-0001
Phone (860) 679-2453

Other identifiers 1

IdentifierTypeStateIssuer
2047513MedicaidCT

Other names 1

  • School of Dental Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
University of Connecticut28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

263 Farmington Ave
#2110
Farmington, CT 06030
Phone (860) 679-2453

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770572588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-2453",
            "fax_number": "860-679-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-2453",
            "fax_number": "860-679-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCONN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LURIE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PROFESSOR",
        "authorized_official_telephone_number": "860-679-2453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "CT",
            "license": "004751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047513",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "School of Dental Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.