CENTER FOR ORAL AND IMPLANT SURGERY OF GREENWICH, LLC (NPI# 1194053942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194053942 |
| Entity Type | Organization |
| Organization Name | CENTER FOR ORAL AND IMPLANT SURGERY OF GREENWICH, LLC |
| Practice Address |
49 Lake Ave Greenwich CT 06830-4501 |
| Practice Telephone | 2036614231 |
| Practice Fax Number | 2036610155 |
| Mailing Telephone | 2036614231 |
| Mailing Fax Number | 2036610155 |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2010-01-19 |
| Authorized Official Name | DR. MICHELE S. BERGEN (PARTNER) |
| Authorized Official Telephone | 2036614231 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
49 LAKE AVE |
| City | GREENWICH |
| State | CT |
| Zip Code | 06830-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508860859 | Stephen Jeffrey Salzer | Otolaryngology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2005-06-01 |
| 1255761482 | Joshua Jablonski | Audiologist | 49 Lake Ave, Suite 103, Greenwich, CT 06830-4501 | 2013-11-25 |
| 1366714180 | Lynne M Haven Md PC | Dermatology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2012-02-09 |
| 1730408261 | Kameron Robert Shahid | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2010-05-24 |
| 1770802357 | Catherine Michels Alonzo | Urology | 49 Lake Ave, Suite 201, Greenwich, CT 06830-4501 | 2010-05-22 |
| 1477799302 | True Care Medical Practice, Inc. | Internal Medicine | 49 Lake Ave, Suite 1b, Greenwich, CT 06830-4501 | 2008-12-24 |
| 1861667016 | Incoronata Lileika | Audiologist | 49 Lake Ave, Greenwich, CT 06830-4501 | 2008-04-29 |
| 1356538607 | Greenwich Neurology | Specialist | 49 Lake Ave, Suite 2-27, Greenwich, CT 06830-4501 | 2007-10-01 |
| 1538353321 | Associates of Otolaryngology PC | Otolaryngology | 49 Lake Ave, Suite 205, Greenwich, CT 06830-4501 | 2007-09-05 |
| 1528262219 | Kapil Rajendra Desai | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2007-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303341 | Cristina Castagna | Physical Therapist | 500 West Putnam Ave, 3rd Floor, Greenwich, CT 06830 | 2020-10-16 |
| 1194334334 | Cognitive and Behavioral Care Center, LLC | Counselor | 55 Old Post Road #2, Suite 2c, Greenwich, CT 06830 | 2020-07-23 |
| 1245866433 | Barbara Edeson Roth | Speech-Language Pathologist | The Nathaniel Witherell Home, 70 Parsonage Road, Greenwich, CT 06830 | 2020-03-19 |
| 1750938932 | Evelyn Ramos | Licensed Practical Nurse | 111 Wilbur Peck Ct, Greenwich, CT 06830 | 2019-08-21 |
| 1134773674 | Alexandra Blair Conway | Psychologist | 55 Holly Hill Lane Suite 170, Greenwich, CT 06830 | 2019-08-01 |
| 1821560871 | Brionna Emily Lyles | Licensed Practical Nurse | 111 Wilbur Court, Greenwich, CT 06830 | 2018-12-31 |
| 1568959815 | Backcountry Wellness Inc. | Social Worker | 7 Lincoln Avenue, Greenwich, CT 06830 | 2018-04-21 |
| 1316455876 | Hillary Rea Bercovici | Counselor | 8 Sound Shore Dr Ste 130, Greenwich, CT 06830 | 2018-01-18 |
| 1689181083 | Coastal Eye Surgeons LLC | Ophthalmology | 600 W Putnam Ave Lowr Level, Greenwich, CT 06830 | 2018-01-07 |
| 1952853814 | Tina M. Crystal | Psychologist | 75 Holly Hill Lane, Suite 300, Greenwich, CT 06830 | 2016-10-26 |
| Find all providers in zip 06830 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720520976 | Stamford Oral and Maxillofacial Surgical Arts LLC | Clinic/Center | 27 Bridge St, Stamford, CT 06905-4501 | 2016-11-04 |
| 1053782060 | Connecticut Center for Oral Facial and Implant Surgery PC | Clinic/Center | 54 Retreat Ave, Hartford, CT 06106-2526 | 2015-10-16 |
| 1992129977 | Lee W. Mcneish Dmd, PC | Clinic/Center | 650 Chase Pkwy, Waterbury, CT 06708-3046 | 2014-02-11 |
| 1104183409 | Central Ctonnecticut Oral Maxillofacial& Implant Surgery, PC | Clinic/Center | 836 Farmington Ave, Suite 223, West Hartford, CT 06119-1505 | 2012-04-12 |
Please comment or provide details below to improve the information on CENTER FOR ORAL AND IMPLANT SURGERY OF GREENWICH, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.