NPIMap

Organization Active NPI

Westport Pediatric Dentistry

  • Pediatric Dentistry
  • Westport, CT
National Provider Identifier
1790035897
Registry record updated Sep 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
10577 Issued in CT
Legal business name
WESTPORT PEDIATRIC DENTISTRY
Practice address
305 Post Rd E
Westport, CT 06880-3613
Phone
(203) 226-5500
Fax
(203) 226-5501
NPI assigned
Sep 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2012

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

Authorized official

Name
Dr. Gordon K. Lee, D.D.S.NPI 1497940001
Title
President
Phone
(203) 226-5500

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 10577 CT Primary

Addresses

Primary practice location

305 Post Rd E
Westport, CT 06880-3613

Mailing address

305 Post Rd E
Westport, CT 06880-3613
Phone (203) 226-5500

National Provider Directory

National Provider Directory

Locations

305 Post Rd E
Westport, CT 06880
Phone (203) 226-5500

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": "1347753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347753600000",
    "number": "1790035897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803613",
            "telephone_number": "203-226-5500",
            "fax_number": "203-226-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068803613",
            "telephone_number": "203-226-5500",
            "fax_number": "203-226-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPORT PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-16",
        "last_updated": "2012-09-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-226-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "10577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2012; 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.