Orange Children's Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

ORANGE CHILDREN'S DENTISTRY, LLC

Practice address

518 Boston Post Rd Ste 4-5
Orange, CT 06477-3554

Phone

(860) 970-2332

NPI assigned

Sep 26, 2018

Last updated

Sep 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula C Cerqueira, DMD

Title

Owner

Phone

(860) 970-2332

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1932684990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 BOSTON POST RD STE 4-5",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773554",
            "telephone_number": "860-970-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 BOSTON POST RD STE 4-5",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773554",
            "telephone_number": "860-970-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE CHILDREN'S DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "CERQUEIRA",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-970-2332",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427027911",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042366354",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Orange, CT
• Providers in Orange, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.