The Elmwood Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8560 Issued in CT

Legal business name

THE ELMWOOD DENTAL GROUP, LLC

Practice address

1132 New Britain Ave
West Hartford, CT 06110-2413

Phone

(860) 236-6928

Fax

(860) 236-6920

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ana Paula Gomes, DMD

Title

Dentist

Phone

(860) 236-6928

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1932246964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102413",
            "telephone_number": "860-236-6928",
            "fax_number": "860-236-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102413",
            "telephone_number": "860-236-6928",
            "fax_number": "860-236-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ELMWOOD DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "PAULA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "860-236-6928",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.