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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
010554 | CT | Dental Providers |
Street Address |
454 PARK ST |
City | HARTFORD |
State | CT |
Zip Code | 06106-1525 |
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 Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
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 |
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 |
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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.