NPIMap

Organization Active NPI

Dental Centers of Fairfiled County LLC

  • General Practice Dentistry
  • Bridgeport, CT
National Provider Identifier
1831476050
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4501 Issued in CT
Legal business name
DENTAL CENTERS OF FAIRFILED COUNTY LLC
Practice address
140 Hurd Ave
Bridgeport, CT 06604-2701
Phone
(203) 371-0119
Fax
(203) 372-3700
NPI assigned
Nov 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Authorized official

Name
Dr. Michael B Montanaro, D.D.S.
Title
Orthodontist
Phone
(203) 257-9250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4501 CT Primary

Addresses

Primary practice location

140 Hurd Ave
Bridgeport, CT 06604-2701

Mailing address

140 Herd Ave
Bridgeport, CT 06604
Phone (203) 371-0119

National Provider Directory

National Provider Directory

Locations

140 Hurd Ave
Bridgeport, CT 06604
Phone (203) 371-0119

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1831476050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HERD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06604",
            "telephone_number": "203-371-0119",
            "fax_number": "203-372-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HURD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042701",
            "telephone_number": "203-371-0119",
            "fax_number": "203-372-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CENTERS OF FAIRFILED COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "MONTANARO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "203-257-9250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "4501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.