Bristol Oral Surgery & Implant Center

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

9812 Issued in CT

Legal business name

BRISTOL ORAL SURGERY & IMPLANT CENTER

Practice address

33 High St
Bristol, CT 06010-5820

Phone

(860) 538-3495

Fax

(860) 645-0349

NPI assigned

Mar 27, 2014

Last updated

Mar 27, 2014By 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. David Aaron Fenton, DDS, MD

Title

Owner / Physician

Phone

(860) 538-3495

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Sue Sayre, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Bristol, CT
  • NPI 1760895866
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1992122956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HIGH ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105820",
            "telephone_number": "860-538-3495",
            "fax_number": "860-645-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 HIGH ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105820",
            "telephone_number": "860-538-3495",
            "fax_number": "860-645-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL ORAL SURGERY & IMPLANT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "860-538-3495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "9812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bristol Hospital Multi Specialty Group, Inc
• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Orthopaedics LLC
• Bristol Pathology Consultants, P.C.
• Bristol Pharmacy LLC (Bristol Pharmacy)
• Bristol Physical Therapy, LLC
• Bristol Plaza Family Dental

• Oral and Maxillofacial Surgery (Dentist) in Bristol, CT
• Providers in Bristol, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.