Fair Haven Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAIR HAVEN DENTAL LLC

Practice address

214 Grand Ave
New Haven, CT 06513-3721

Phone

(860) 863-5831

NPI assigned

Nov 17, 2013

Last updated

Nov 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sandeep Jagini, DMD

Title

Member

Phone

(617) 306-0017

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1384646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384646400000",
    "number": "1982034658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 QUEEN ST",
            "address_2": "SUITE 3",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064891547",
            "telephone_number": "860-863-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133721",
            "telephone_number": "860-863-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR HAVEN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-17",
        "last_updated": "2013-11-17",
        "status": "A",
        "authorized_official_last_name": "JAGINI",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "617-306-0017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fair Haven Community Health Clinic Inc. (Fair haven Community Health Center)
• Fair Haven Community Health Clinic, Inc (Fair Haven Community Health Center)
• Fair Haven Community Health Clinic, Inc
• Fair Haven Community Health Clinic, Inc (Grand Pharmacy 374)
• Fair Haven Community Health Clinic, Inc (Fair Haven Community Health Center)
• Fair Haven Pharmacy LLC
• Barbara Jean Fair, LCSW
• Susan Fair, P.A.-C.
• Melissa Gerardi Fairbairn, PA-C
• Victoria Christine Fairchild, MD

• General Practice Dentistry in New Haven, CT
• Providers in New Haven, 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 Nov 17, 2013; 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.