NPIMap

Organization Active NPI

Northhavenfamilydental

  • Dentist
  • North Haven, CT
National Provider Identifier
1962949206
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
010930 Issued in CT
Legal business name
NORTHHAVENFAMILYDENTAL
Practice address
323 Universal Dr N
North Haven, CT 06473-3154
Phone
(215) 421-7576
NPI assigned
Jan 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Dr. Lakshmi Bethi, DMD
Title
General Dentist
Phone
(215) 421-7576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 010930 CT Primary

Addresses

Primary practice location

323 Universal Dr N
North Haven, CT 06473-3154

Mailing address

25 Lexie Lane
Southwindsor, CT 06074
Phone (215) 421-7576

Other identifiers 1

IdentifierTypeStateIssuer
010930MedicaidCT

National Provider Directory

National Provider Directory

Locations

323 Universal Dr N
North Haven, CT 06473
Phone (203) 234-1785

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1962949206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LEXIE LANE",
            "city": "SOUTHWINDSOR",
            "state": "CT",
            "postal_code": "06074",
            "telephone_number": "215-421-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 UNIVERSAL DR N",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733154",
            "telephone_number": "215-421-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHHAVENFAMILYDENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "BETHI",
        "authorized_official_first_name": "LAKSHMI",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "215-421-7576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010930",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.