NPIMap

Organization Active NPI

SPH3 Enterprise, LLC

Doing business as Buckland Hills Dental

  • General Practice Dentistry
  • Manchester, CT
National Provider Identifier
1972893352
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009846 Issued in CT
Legal business name
SPH3 ENTERPRISE, LLC
Doing business as
Buckland Hills Dental
Practice address
194 Buckland Hills Dr
Manchester, CT 06042-8705
Phone
(860) 342-4141
Fax
(860) 342-1284
NPI assigned
Apr 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Tae Chul Ho, DDS
Title
Dentist
Phone
(860) 342-4141

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 009846 CT Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 009920 CT
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 009785 CT
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X

Addresses

Primary practice location

194 Buckland Hills Dr
Manchester, CT 06042-8705

Mailing address

553 Portland-Cobalt Rd
Portland, CT 06480
Phone (860) 342-4141

Other names 1

  • Buckland Hills Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Buckland Hills Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1972893352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 PORTLAND-COBALT RD",
            "city": "PORTLAND",
            "state": "CT",
            "postal_code": "06480",
            "telephone_number": "860-342-4141",
            "fax_number": "860-342-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 BUCKLAND HILLS DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428705",
            "telephone_number": "860-342-4141",
            "fax_number": "860-342-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPH3 ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "TAE",
        "authorized_official_middle_name": "CHUL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "860-342-4141",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009846",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009920",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009785",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckland Hills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.