PARK STREET FAMILY DENTAL


Address: 454 Park St, Hartford, CT 06106-1525
Phone: 8609442802

PARK STREET FAMILY DENTAL (NPI# 1518234079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518234079
Entity Type Organization
Organization Name PARK STREET FAMILY DENTAL
Practice Address 454 Park St
Hartford
CT 06106-1525
Practice Telephone 8609442802
Mailing Telephone 8609442802
Enumeration Date 2011-11-28
Last Update Date 2011-11-28
Authorized Official Name KRISHNAPRASANTH MUDUSU (OWNER)
Authorized Official Telephone 8609442802
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
010554 CT Dental Providers

Office Location

Street Address 454 PARK ST
City HARTFORD
State CT
Zip Code 06106-1525

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1750907325 Vartika Kesarwani Student in an Organized Health Care Education/Training Program Hartford Hospital Adult Primary Care-brown Stone, 79 Retreat Avenue, Hartford, CT 06106 2020-06-19
1720602865 Meher Kaur Singha Student in an Organized Health Care Education/Training Program Hartford Hospital Adult Primary Care- Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 2020-06-04
1497314140 Eduardo Mantovani Cardoso Student in an Organized Health Care Education/Training Program Hartford Hospital Adut Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 2019-06-06
1114582178 Dimitrios Drekolias Student in an Organized Health Care Education/Training Program Hartford Hospital Adult Primary Care - Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 2019-05-06
1316501687 Rafae Shaikh Student in an Organized Health Care Education/Training Program Hartford Hospital Adult Primary Care Brown Stone, 79 Retreat Avenue, Hartford, CT 06106 2019-04-23
1437643715 Lucas Bensa Social Worker 421 Washington St., Apt C1, Hartford, CT 06106 2018-06-19
1548754310 Collin Dimler Physician Assistant 85 Seymour St Ste 1003, Hartford, CT 06106 2018-06-15
1619460581 Bryan F Stringer Student in an Organized Health Care Education/Training Program 79 Retreat Ave., Hh-adult Primary Care - Brown Stone, Hartford, CT 06106 2018-06-14
1083103972 Margret Sigurdardottir Blondal Student in an Organized Health Care Education/Training Program 282 Washington Street, Ste 4h, Hartford, CT 06106 2018-05-07
1265920995 Rudra Ramanathan Student in an Organized Health Care Education/Training Program 79 Retreat Ave Brown Stone, Hartford, CT 06106 2018-04-27
Find all providers in zip 06106

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295374296 The Smile Studio At Bushnell Park Dentist 1 Gold St Ste Q, Hartford, CT 06103-2914 2019-12-23
1013417112 Nicholas Oliveri Dentist 37 Airport Rd, Hartford, CT 06114-2002 2018-02-15
1295242238 Family Dentistry of Hartford Pllc Dentist 19 Woodland St Ste 25, Hartford, CT 06105-2335 2017-12-29
1154847044 Na Won Lee Dentist 191 Franklin Ave., Care Dental Center, Hartford, CT 06114 2017-08-22
1588005243 Tooth & Gums Dentistry Dentist 1500 Albany Ave, Hartford, CT 06112-2113 2013-07-10
1083955348 K & L Dental LLC Dentist 629 Albany Ave, Hartford, CT 06112-2334 2013-03-12
1023325255 Janyn Khresty Baird Dentist 550 Farmington Ave, Hartford, CT 06105-3049 2010-09-09
1407006133 Mang Chou Shu Dentist 1 Financial Plz Fl 19, Hartford, CT 06103-2608 2008-09-30
1841454725 Loay Hammad Dentist 31 William Shorty Campbell St, Hartford, CT 06106-3401 2008-07-10
1669632790 Michael E Darga Dentist 57 S Main Street, Hartford, WI 53027-1866 2008-06-12
Find all providers in HARTFORD

Competitor

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City HARTFORD
Zip Code 06106

Improve Information

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Dataset Information

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.

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