Conway Ma, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13322 Issued in CT

Practice address

12 Goose LN
Tolland, CT 06084-3400

Phone

(860) 875-6269

NPI assigned

Mar 18, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Sleep Providers, LLC

  • Durable Medical Equipment & Medical Supplies
  • Manchester, CT
  • NPI 1336613330

  General Practice

  NPD (past)
• Manchester Family Dental LLC

  • General Practice Dentistry
  • Manchester, CT
  • NPI 1326317827
  NPD (past)

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1891156816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JONES CT",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063606002",
            "telephone_number": "860-822-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GOOSE LN",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843400",
            "telephone_number": "860-875-6269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1178 Parker St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011291030",
            "country_code": "US",
            "telephone_number": "413-783-5787",
            "fax_number": "413-783-4577",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "945 Main St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060406064",
            "country_code": "US",
            "telephone_number": "860-643-5350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "CONWAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857687",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "13322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen L Little, LCSW
• Gina Longo
• Geena Lovallo, LMFT
• Theresa C Luddecke, COTA/L
• Katlin Luu
• Marcia Lynn Machuga, RD-CDN
• Rachel Lynn Maclean, PA-C
• Kendal B Mainville, PT
• Ryan William Maringola, PA
• Zachary Gavin Martinez, D.D.S.

• General Practice Dentistry in Tolland, CT
• Providers in Tolland, 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 Dec 21, 2023; 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.