SPH ENTERPRISE LLC


Address: 161 Boston Ave, Bridgeport, CT 06610-1662
Phone: 2038730598

SPH ENTERPRISE LLC (NPI# 1609199074) 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) 1609199074
Entity Type Organization
Organization Name SPH ENTERPRISE LLC
Other Organization Name BRIDGEPORT FAMILY DENTAL GROUP
Practice Address 161 Boston Ave
Bridgeport
CT 06610-1662
Practice Telephone 2038730598
Mailing Telephone 2038730598
Enumeration Date 2010-03-12
Last Update Date 2014-05-08
Authorized Official Name DIANE DEVRIES (BUSINESS MANAGER)
Authorized Official Telephone 2038730598
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223G0001X Dentist
Specialization: General Practice
009846 CT Dental Providers
N 1223G0001X Dentist
Specialization: General Practice
009920 CT Dental Providers
N 1223P0221X Dentist
Specialization: Pediatric Dentistry
Dental Providers
N 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
010946 CT Dental Providers
Y 1223G0001X Dentist
Specialization: General Practice
009785 CT Dental Providers

Other Provider/Organization Names

Other Name Type Code
Bridgeport Family Dental Group Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1942450754 Sph Enterprise LLC Dentist 169 Center St, Shelton, CT 06484 2008-09-29

Office Location

Street Address 161 BOSTON AVE
City BRIDGEPORT
State CT
Zip Code 06610-1662

Providers in the same location

NPI Name Taxonomy Address Enumeration
1629564729 Carly Krisavage Physician Assistant 161 Boston Ave, Bridgeport, CT 06610-1662 2018-07-02
1194193094 Sph Bridgeport, LLC Dentist 161 Boston Ave, Bridgeport, CT 06610-1662 2015-09-09
1487087250 Quentin Medical Group, LLC Clinic/Center 161 Boston Ave, Bridgeport, CT 06610-1662 2013-08-16
1437432671 Heungjoo Sung Dentist 161 Boston Ave, Bridgeport, CT 06610-1662 2011-09-23
1619268745 Waseem Shahid Family Medicine 161 Boston Ave, Bridgeport, CT 06610-1662 2011-04-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215553698 Juan G Farfan Nurse Anesthetist, Certified Registered 267 Grant Sreet, Bridgeport, CT 06610 2020-06-22
1104446145 Deepak Rajkumar Vangipuram Student in an Organized Health Care Education/Training Program Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-20
1275152886 Soniya Abraham Student in an Organized Health Care Education/Training Program Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-14
1538621834 Yu Mi Kang Student in an Organized Health Care Education/Training Program 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 2019-04-04
1073075024 Ashwin Pramod Deshmukh Student in an Organized Health Care Education/Training Program Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2019-04-01
1790246866 Prachi Mangesh Pednekar Student in an Organized Health Care Education/Training Program Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 2019-03-29
1194247916 Jessica M. Maddern Social Worker 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 2017-07-13
1922532746 Megha Kureti Student in an Organized Health Care Education/Training Program 267 Grant St Fl 3, Bridgeport, CT 06610 2017-04-18
1831623099 Cynthia Joseph Walters Nurse Anesthetist, Certified Registered Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 2017-04-14
1285186148 Helen Leahy Nurse Practitioner 439 Mill Hill Ave., Bridgeport, CT 06610 2016-10-26
Find all providers in zip 06610

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
1891355814 Kristopher Antonio Yen Dentist 32 Kathryn Dr, Bridgeport, CT 06610-1264 2019-06-20
1407239379 Oliver Sun Dentist 3885 Main St Ste 101, Bridgeport, CT 06606-2814 2015-07-09
1679970172 Aarti Jawa Dentist 594 Pequonnoack Street, Bridgeport, CT 06604 2014-11-26
1588064349 Siz, LLC Dentist 1041-1043 East Main Street, Bridgeport, CT 06608-1916 2014-08-29
1306269758 Dr.dental of Bridgeport PC Dentist 1700 Park Ave., Bridgeport, CT 06604-3826 2014-01-21
1700144714 Hamed Ghorbani-moghaddam Dentist 2690 E Main St, Columbia Dental, Bridgeport, CT 06610-1422 2012-04-26
1831476050 Dental Centers of Fairfiled County LLC Dentist 140 Hurd Ave, Bridgeport, CT 06604-2701 2011-11-16
1124308184 Family Dentistry of Bridgeport P.C. Dentist 90 Brooklawn Ave, Bridgeport, CT 06604-2010 2011-08-23
1861789034 Bridgeport Dental Care, LLC Dentist 2417 E Main St, Bridgeport, CT 06610-1802 2011-07-07
1154628477 Bridgeport Dentist Dentist 2992 Main St, Bridgeport, CT 06606-4226 2011-02-23
Find all providers in BRIDGEPORT

Competitor

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City BRIDGEPORT
Zip Code 06610

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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