NPIMap

Organization Active NPI

Just4Kidzdentistry

  • Pediatric Dentistry
  • Southington, CT
National Provider Identifier
1790116036
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
008492 Issued in CT
Legal business name
JUST4KIDZDENTISTRY
Practice address
1115 West St
Suite #4
Southington, CT 06489-1023
Phone
(860) 426-1470
NPI assigned
Dec 12, 2013
Last updated
Dec 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Dr. Celeste Wegrzyn Religa, D.M.D.
Title
Owner
Phone
(860) 426-1470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 008492 CT Primary

Addresses

Primary practice location

1115 West St
Suite #4
Southington, CT 06489-1023

Mailing address

1115 West St
Suite #4
Southington, CT 06489-1023
Phone (860) 426-1470

National Provider Directory

National Provider Directory

Locations

1115 West St
Ste 4
Southington, CT 06489
Phone (860) 426-1470

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1790116036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEST ST",
            "address_2": "SUITE #4",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891023",
            "telephone_number": "860-426-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 WEST ST",
            "address_2": "SUITE #4",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891023",
            "telephone_number": "860-426-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST4KIDZDENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "RELIGA",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "WEGRZYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-426-1470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "008492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.