Meriden Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010110 Issued in CT

Legal business name

MERIDEN DENTAL ASSOCIATES, LLC

Practice address

1011 Main St
East Hartford, CT 06108-2294

Phone

(860) 528-3350

NPI assigned

May 8, 2012

Organization subpart

No

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

Authorized official

Name

Chia Hui Jenny Kwon

Title

Member

Phone

(917) 453-4055

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1972862266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 BROAD ST FL 2",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504395",
            "telephone_number": "860-528-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MAIN ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082294",
            "telephone_number": "860-528-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDEN DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHIA HUI",
        "authorized_official_middle_name": "JENNY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-453-4055"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010110",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "010004",
            "primary": false
        }
    ],
    "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 May 8, 2012; 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.