NPIMap

Organization Active NPI

City of Bridgeport Department of Health

  • Dental Clinic/Center
  • Bridgeport, CT
National Provider Identifier
1952426330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CITY OF BRIDGEPORT DEPARTMENT OF HEALTH
Doing business as
School Based Health Center
Practice address
752 E Main St
Bridgeport, CT 06608-2335
Phone
(203) 576-7052
Fax
(203) 332-5641
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mariam Evans
Title
Director of Health
Phone
(203) 576-7680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

752 E Main St
Bridgeport, CT 06608-2335

Mailing address

752 E Main St
Bridgeport, CT 06608-2335
Phone (203) 576-7052

Other names 1

  • School Based Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Hygiene Division14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952426330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082335",
            "telephone_number": "203-576-7052",
            "fax_number": "203-332-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082335",
            "telephone_number": "203-576-7052",
            "fax_number": "203-332-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BRIDGEPORT DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH",
        "authorized_official_telephone_number": "203-576-7680",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.