West Haven Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010017 Issued in CT

Legal business name

WEST HAVEN DENTAL LLC

Practice address

666 Campbell Ave
West Haven, CT 06516-3775

Phone

(646) 361-7570

Fax

(203) 873-0710

NPI assigned

Feb 22, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dong K Kim, DDS

Title

President

Phone

(646) 361-7570

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1861765711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 ORCHARD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501326",
            "telephone_number": "646-361-7570",
            "fax_number": "201-313-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163775",
            "telephone_number": "646-361-7570",
            "fax_number": "203-873-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HAVEN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-361-7570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick M Welch, APRN
• Alesia Wellington, LCSW
• Danielle Wesolowicz, PHD
• West Haven Board of Education
• West Haven Center for Nursing & Rehabilitation, LLC
• West Haven Markets Inc
• West Haven Medical Group, LLC
• West Haven Medical Group, LLC
• West Haven Pediatrics, LLC
• West Haven Pediatrics, LLC

• General Practice Dentistry in West Haven, CT
• Providers in West Haven, 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 Feb 22, 2012; 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.