NPIMap

Organization Active NPI

Pediatric Dental Assoc P.C.

  • Pediatric Dentistry
  • Manchester, CT
National Provider Identifier
1851329510
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL ASSOC P.C.
Practice address
192 Main St
Manchester, CT 06042-3581
Phone
(860) 649-4655
Fax
(860) 646-3281
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Ms. Eileen M. Perkins
Title
Office Manager
Phone
(860) 649-4655

Specialties & licenses 1

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

Addresses

Primary practice location

192 Main St
Manchester, CT 06042-3581

Mailing address

192 Main St
Manchester, CT 06042-3581
Phone (860) 649-4655

National Provider Directory

National Provider Directory

Locations

192 Main St
Manchester, CT 06042
Phone (860) 649-4655

Practitioners & affiliated clinicians

Practitioners 4

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1851329510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423581",
            "telephone_number": "860-649-4655",
            "fax_number": "860-646-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423581",
            "telephone_number": "860-649-4655",
            "fax_number": "860-646-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-649-4655",
        "authorized_official_name_prefix": "Ms."
    },
    "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 Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.