NPIMap

Organization Active NPI

New Haven Implant and Oral Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • New Haven, CT
National Provider Identifier
1992109656
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
NEW HAVEN IMPLANT AND ORAL SURGERY, LLC
Practice address
1423 Chapel St
Unit 3C
New Haven, CT 06511-4411
Phone
(203) 787-6581
NPI assigned
Oct 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Dr. Jordan Greenberg, D.D.S.NPI 1629218961
Title
Member/President
Phone
(914) 355-0840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1423 Chapel St
Unit 3C
New Haven, CT 06511-4411

Mailing address

1423 Chapel St
Unit 3C
New Haven, CT 06511-4411
Phone (203) 787-6581

Other names 1

  • Connecticut Implant and Oral Surgery Specialists, LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1992109656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 CHAPEL ST",
            "address_2": "UNIT 3C",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114411",
            "telephone_number": "203-787-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHAPEL ST",
            "address_2": "UNIT 3C",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114411",
            "telephone_number": "203-787-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN IMPLANT AND ORAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "914-355-0840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Implant and Oral Surgery Specialists, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.