Leonardo Pena-Abosaid, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008770 Issued in CT

Practice address

373 Nichols Ave
Stratford, CT 06614-3905

Phone

(203) 377-6418

Fax

(203) 377-5477

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Stratford Dental Care PC

  • General Practice Dentistry
  • Stratford, CT
  • NPI 1609886480
  NPD (past) Authorized official

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1962600718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 NICHOLS AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143905",
            "telephone_number": "203-377-6418",
            "fax_number": "203-377-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 NICHOLS AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066143905",
            "telephone_number": "203-377-6418",
            "fax_number": "203-377-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA-ABOSAID",
        "first_name": "LEONARDO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Patria, D.C.
• Patrick Gagnon LLC
• Paul Furino Aprn LLC
• Richard William Pecoroni, M.A.
• Pediatric Smiles LLC
• Kristi Alexis Pena, OTR/L
• Penta Dental LC
• Diolenny Perez, LPN
• Daniel Perillo
• Personal Growth Concepts, Inc.

• General Practice Dentistry in Stratford, CT
• Providers in Stratford, 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 Mar 23, 2015; 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.