NPIMap

Organization Active NPI

Haven Pediatric Dentistry,LLC

  • Pediatric Dentistry
  • West Haven, CT
National Provider Identifier
1801044854
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
HAVEN PEDIATRIC DENTISTRY,LLC
Practice address
100 Elm St
West Haven, CT 06516-3810
Phone
(203) 933-0008
Fax
(203) 931-1433
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Dr. Jesus A Villegas, DDS
Title
Member/Dentist
Phone
(203) 933-0008

Specialties & licenses 1

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

Addresses

Primary practice location

100 Elm St
West Haven, CT 06516-3810

Mailing address

100 Elm St
West Haven, CT 06516-3810
Phone (203) 933-0008

National Provider Directory

National Provider Directory

Locations

100 Elm St
West Haven, CT 06516
Phone (203) 931-1433

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": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1801044854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELM ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163810",
            "telephone_number": "203-933-0008",
            "fax_number": "203-931-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELM ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163810",
            "telephone_number": "203-933-0008",
            "fax_number": "203-931-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN PEDIATRIC DENTISTRY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "VILLEGAS",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER/DENTIST",
        "authorized_official_telephone_number": "203-933-0008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.