Coastal Connecticut Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

COASTAL CONNECTICUT ORAL & MAXILLOFACIAL SURGERY

Practice address

246 Goose LN Ste 204
Guilford, CT 06437-2186

Phone

(203) 453-7700

Fax

(203) 458-5085

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David P. Salomon, DDS

Title

Owner

Phone

(203) 458-4450

Specialties & licenses 1

Addresses

Other names 1

• Hamden Shoreline Oral and Maxillofacial Surgery Former legal business name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Paul Saggese, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Guilford, CT
  • NPI 1013369487
  Medicare reassignment NPD
• Jiean Joseph Heifetz-Li, DMD, MPH

  • Oral and Maxillofacial Surgery (Dentist)
  • Guilford, CT
  • NPI 1053841197
  NPD
• Seth J Matton, MD, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lyme, CT
  • NPI 1609165521
  NPD (past)
• Bryan Meriam, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Guilford, CT
  • NPI 1285869107
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1811199458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 GOOSE LN STE 204",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372186",
            "telephone_number": "203-453-7700",
            "fax_number": "203-458-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 GOOSE LN STE 204",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372186",
            "telephone_number": "203-453-7700",
            "fax_number": "203-458-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2560 Dixwell Ave",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065141851",
            "country_code": "US",
            "telephone_number": "203-281-3737",
            "fax_number": "203-230-2931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL CONNECTICUT ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "SALOMON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-458-4450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamden Shoreline Oral and Maxillofacial Surgery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Zeno N. Chicarilli, M.D., D.M.D.
• Child Neurology Associates LLP
• Lori Lynn Ciccone, PA
• Clara Bowron LLC
• Samantha Elizabeth Clifford, LMSW
• Patricia Jane Colburn
• Dori A. Cole
• Gail Ruth Cole, MS, R.D., CDN
• Beth Ann Collins, M.D.
• Condon Psychiatry PLLC

• Oral and Maxillofacial Surgery (Dentist) in Guilford, CT
• Providers in Guilford, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.