Gorgeous Smiles Dental Southington

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GORGEOUS SMILES DENTAL SOUTHINGTON

Practice address

775 Queen St
Southington, CT 06489-1531

Phone

(860) 965-5995

NPI assigned

Dec 8, 2023

Organization subpart

Yes

Parent organization

GORGEOUS SMILES SOUTHINGTONAs reported in NPPES

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

Authorized official

Name

Raymond Joseph Belisle, COO

Title

Chief Operating Officer

Phone

(860) 978-3294

Specialties & licenses 1

Addresses

Other names 2

• Gorgeous Smiles Southington Doing business as
• Samreen, LLC Former legal business name

Part of

Gorgeous Smiles Dental Southington

Locations

Practitioners 1

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

• Mohammad Abbas Khan, DMD

  • Dentist
  • South Windsor, CT
  • NPI 1366952897

  General Practice

  NPD

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1831966936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 QUEEN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891531",
            "telephone_number": "860-965-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 QUEEN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891531",
            "telephone_number": "860-965-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORGEOUS SMILES DENTAL SOUTHINGTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GORGEOUS SMILES SOUTHINGTON",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "BELISLE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "860-978-3294",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gorgeous Smiles Southington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samreen, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• General Medical Practice Associates, P.C.
• Vickie Christine Gerdon, PA-C
• Kristin D Gilbert, OTR/L
• Shayla Giles
• Rachel Godburn
• Brittney Ann Gracia, BCBA, LBA
• Grateful Soul Counseling, LLC
• Marissa Graziano
• Marissa Greene, MT-BC
• Pamela J Greene, RPT

• General Practice Dentistry in Southington, CT
• Providers in Southington, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.