Wintonbury Dental Associates, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

005845 Issued in CT

Legal business name

WINTONBURY DENTAL ASSOCIATES, P.C.

Practice address

2 Wintonbury Mall
Bloomfield, CT 06002-2466

Phone

(860) 243-5451

Fax

(860) 656-6107

NPI assigned

Aug 26, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Alphonso L Mack, D.M.D.NPI 1043237704

Title

President

Phone

(860) 243-5451

Specialties & licenses 1

Addresses

Other names 1

• Wintonbury Dental Associates Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alphonso L. Mack, D.M.D.

  • General Practice Dentistry
  • Bloomfield, CT
  • NPI 1043237704
  NPD (past) Authorized official

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1982837845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WINTONBURY MALL",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022466",
            "telephone_number": "860-243-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WINTONBURY MALL",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022466",
            "telephone_number": "860-243-5451",
            "fax_number": "860-656-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTONBURY DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "ALPHONSO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-243-5451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "005845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wintonbury Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Williams, APRN
• Rashad George Williams, LMSW
• Joon Wilson
• Wilton Anesthesia Associates, LLC
• Wintonbury Care Center LLC
• Stephen George Wolfe, MD
• Catherine Worthley, APRN
• Brianna Wright, DPT
• Tiffany F Wright
• WVJ Companion Services, LLC

• General Practice Dentistry in Bloomfield, CT
• Providers in Bloomfield, 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 Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.