MCM DENTAL, LLC (NPI# 1235599333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235599333 |
| Entity Type | Organization |
| Organization Name | MCM DENTAL, LLC |
| Practice Address |
74 Main Street Lakewood CT 06451 |
| Mailing Address |
74 Main St Meriden CT 06451-5119 |
| Practice Telephone | 2032350121 |
| Practice Fax Number | 2032356337 |
| Mailing Telephone | 2032350121 |
| Mailing Fax Number | 2032356337 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |
| Authorized Official Name | MAXWELL BOATEY (OWNER) |
| Authorized Official Telephone | 2032350121 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 11072 | CT | Dental Providers |
| Street Address |
74 MAIN STREET |
| City | LAKEWOOD |
| State | CT |
| Zip Code | 06451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
| 1144522160 | Community Renewal Team Inc. | Case Management | 675 Tower Ave, Hartford, CT 06451 | 2010-11-23 |
| Find all providers in zip 06451 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760025894 | Lakewood Dental Associates, LLC | Dentist | 838 River Ave Ste 1, Lakewood, NJ 08701-5279 | 2019-10-22 |
| 1851933287 | Jeri A. Logan | Dentist | 8064 W Jewell Ave Unit 100, Lakewood, CO 80232-6710 | 2019-10-17 |
| 1457838294 | Narges Lotfizadeh Dehkordi | Dentist | 5605 Lakewood Towne Center Blvd Sw Ste B, Lakewood, WA 98499-3855 | 2018-07-24 |
| 1770069239 | Jeffrey A. Osborn | Dentist | 8520 Steilacoom Blvd Sw Ste 202, Lakewood, WA 98498-4773 | 2018-07-17 |
| 1790279743 | Andrew Montalvo | Dentist | 12375 W Auburn Dr, Lakewood, CO 80228-4747 | 2018-06-21 |
| 1508376906 | Green Gables Dental LLC | Dentist | 7586 W Jewell Ave # 2-303, Lakewood, CO 80232-6890 | 2017-10-11 |
| 1073964284 | Travis Jay Barr | Dentist | 3333 S Wadsworth Blvd Unit D305, Lakewood, CO 80227-5142 | 2016-06-29 |
| 1285094672 | Danijela Jankovic | Dentist | 7611 W.colfax Avenue, Suite D, Lakewood, CO 80214 | 2016-02-29 |
| 1831556117 | John Kim | Dentist | 10011 Bridgeport Way Sw, Ste 700, Lakewood, WA 98499-2332 | 2016-01-18 |
| 1811361751 | Simple Smiles, Pllc | Dentist | 225 S Sheridan Blvd Ste 114, Lakewood, CO 80226-2405 | 2015-11-16 |
| Find all providers in LAKEWOOD | ||||
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| 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.