NPIMap

Organization Active NPI

CT Dental LLC

Doing business as Connecticut Family Dental

  • General Practice Dentistry
  • Waterbury, CT
National Provider Identifier
1881987964
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010282 Issued in CT
Legal business name
CT DENTAL LLC
Doing business as
Connecticut Family Dental
Practice address
171 Grandview Ave
Suite 103
Waterbury, CT 06708-2517
Phone
(203) 574-2725
Fax
(203) 574-2726
NPI assigned
May 23, 2011
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Dr. Tulasi N Vikram, DDSNPI 1174836134
Title
Owner
Phone
(203) 574-2725

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X 010282 CT Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X CT

Addresses

Primary practice location

171 Grandview Ave
Suite 103
Waterbury, CT 06708-2517

Mailing address

171 Grandview Ave
Suite 103
Waterbury, CT 06708-2517
Phone (203) 574-2725

Other names 1

  • Connecticut Family Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1881987964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE",
            "address_2": "SUITE 103",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082517",
            "telephone_number": "203-574-2725",
            "fax_number": "203-574-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 GRANDVIEW AVE",
            "address_2": "SUITE 103",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082517",
            "telephone_number": "203-574-2725",
            "fax_number": "203-574-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "VIKRAM",
        "authorized_official_first_name": "TULASI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-574-2725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010282",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.