NPIMap

Organization Active NPI

Brilliant Smile Dental, P.C.

  • General Practice Dentistry
  • Meriden, CT
National Provider Identifier
1912364860
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
CT011025 Issued in CT
Legal business name
BRILLIANT SMILE DENTAL, P.C.
Practice address
725 E Main St
Meriden, CT 06450-6005
Phone
(203) 235-4930
NPI assigned
Jan 24, 2016
Last updated
Mar 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Dr. In Kyung Lee, DDSNPI 1215369574
Title
General Dentist
Phone
(203) 235-4930

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X CT011025 CT Primary

Addresses

Primary practice location

725 E Main St
Meriden, CT 06450-6005

Mailing address

725 E Main St
Meriden, CT 06450-6005
Phone (203) 235-4930

National Provider Directory

National Provider Directory

Locations

725 E Main St
Meriden, CT 06450
Phone (203) 235-4930

Practitioners & affiliated clinicians

Practitioners 3

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": "1453593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1912364860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E MAIN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506005",
            "telephone_number": "203-235-4930",
            "fax_number": "203-235-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E MAIN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064506005",
            "telephone_number": "203-235-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT SMILE DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-24",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "IN KYUNG",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "203-235-4930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT011025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.