NEW HAVEN IMPLANT AND ORAL SURGERY, LLC (NPI# 1992109656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992109656 |
| Entity Type | Organization |
| Organization Name | NEW HAVEN IMPLANT AND ORAL SURGERY, LLC |
| Other Organization Name | CONNECTICUT IMPLANT AND ORAL SURGERY SPECIALISTS, LLC |
| Practice Address |
1423 Chapel St Unit 3c New Haven CT 06511-4411 |
| Practice Telephone | 2037876581 |
| Mailing Telephone | 2037876581 |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-22 |
| Authorized Official Name | DR. JORDAN GREENBERG (MEMBER/PRESIDENT) |
| Authorized Official Telephone | 9143550840 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Connecticut Implant and Oral Surgery Specialists, LLC | Former Legal Business Name - Organization |
| Street Address |
1423 CHAPEL ST UNIT 3C |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-4411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962491803 | Robert R Sorrentino | Dentist | 1423 Chapel St, New Haven, CT 06511-4411 | 2005-10-13 |
| 1952755563 | Nia Health Group LLC | Naturopath | 1423 Chapel St, New Haven, CT 06511-4411 | 2016-04-20 |
| 1386000941 | Primary Care and Walk In LLC | Internal Medicine | 1423 Chapel St, 1 B, New Haven, CT 06511-4411 | 2016-01-12 |
| 1780089698 | Elisabeth Makubika | Nurse Practitioner | 1423 Chapel St, 1-a, New Haven, CT 06511-4411 | 2014-11-04 |
| 1174925606 | Peoples Home Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 1423 Chapel St, 3b, New Haven, CT 06511-4411 | 2014-09-16 |
| 1023419587 | Parvez Baig Dmd Corporation | Dentist | 1423 Chapel St, Suite 3a, New Haven, CT 06511-4411 | 2014-09-15 |
| 1265862098 | Jillian Sacco | Nurse Anesthetist, Certified Registered | 1423 Chapel St, New Haven, CT 06511-4411 | 2013-11-14 |
| 1407280647 | Jillian Nicole Buturla | Nurse Practitioner | 1423 Chapel St, 2b, New Haven, CT 06511-4411 | 2013-08-23 |
| 1528310521 | Michael Liam Flaherty | Nurse Anesthetist, Certified Registered | 1423 Chapel St, New Haven, CT 06511-4411 | 2012-10-15 |
| 1497039432 | Nelson J Pettey | Nurse Anesthetist, Certified Registered | 1423 Chapel St, New Haven, CT 06511-4411 | 2011-10-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330571 | Allison Elizabeth Pratt | Occupational Therapist | 625 Whitney Ave, Apt 5, New Haeven, CT 06511 | 2020-09-11 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1083268395 | Danielle Lee Mcpherson | Pharmacist | Yale New Haven Hospital 55 Park Street, New Haven, CT 06511 | 2019-07-25 |
| 1528533866 | Alexia Levin | Social Worker | 98/100 York St, New Haven, CT 06511 | 2018-10-12 |
| 1861970097 | Orthocare Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1450 Chapel St Ste Sg15, New Haven, CT 06511 | 2018-07-31 |
| 1609352418 | Susannah Frew | Social Worker | 2 Eld Street, Apt 6, New Haven, CT 06511 | 2018-07-15 |
| 1851881965 | Empowerment Counseling Services, LLC | Counselor | 427 Dixwell Ave, New Haven, CT 06511 | 2018-05-14 |
| 1487173951 | Karine Giasson-gariepy | Student in an Organized Health Care Education/Training Program | Yale University Department of Psychiatry, 300 George Street, Suite 901, New Haven, Ct 06511, New Haven, CT 06511 | 2017-09-15 |
| 1568980696 | Anna Reutenauer | Dentist | 123 York St Ste 4l, New Haven, CT 06511 | 2017-09-08 |
| 1083134753 | Darin Dolezal | Student in an Organized Health Care Education/Training Program | 200 South Frontage Road, Ep2 2nd Floor - 612, Dept of Pathology, New Haven, CT 06511 | 2017-06-23 |
| Find all providers in zip 06511 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
|---|---|---|---|---|
| 1629218961 | Jordan A. Greenberg | Dentist | 1423 Chapel St Ste 3c, New Haven, CT 06511-4411 | 2009-02-26 |
| 1962491803 | Robert R Sorrentino | Dentist | 1423 Chapel St, New Haven, CT 06511-4411 | 2005-10-13 |
| 1326424995 | Princeps Healthcare | Dentist | 881 Whalley Ave, New Haven, CT 06515-1728 | 2015-08-06 |
| 1528453883 | Yale-new Haven Hospital | Dentist | 1450 Chapel St, Oral & Maxillofacial Surgery, New Haven, CT 06511-4405 | 2015-04-03 |
| 1063700037 | Oral and Maxillofacial Surgical Associates, PC | Dentist | 1423 Chapel St, Third Floor, New Haven, CT 06511-4411 | 2011-07-12 |
| 1235257148 | Oral & Maxillofacial Surgery Associates of Greater New Haven, P.C. | Dentist | 136 Sherman Ave, Suite #402, New Haven, CT 06511-5238 | 2007-03-27 |
| 1386685022 | John Patrick Washington Kelly | Dentist | 1450 Chapel St, Mob-2, New Haven, CT 06511-4405 | 2006-06-10 |
| 1699713016 | Leonard Warren Skope | Dentist | 136 Sherman Ave, Suite #402, New Haven, CT 06511-5238 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053951350 | Connecticut Oral Surgery and Implant Center, Pllc | Dentist | 314 Flanders Rd Ste 1b, East Lyme, CT 06333-1727 | 2020-01-14 |
| 1952898025 | Premier Oral Surgery and Implantology Center LLC | Dentist | 411 Barnum Avenue Cutoff Ste 5, Stratford, CT 06614-5100 | 2018-04-15 |
| 1629595145 | Gary Fishbein Dmd LLC | Dentist | 281 Hartford Tpke Ste 307, Vernon, CT 06066-4707 | 2017-08-25 |
| 1912428160 | Gm Surgical Associates LLC | Dentist | 130 New London Tpke Ste 3, Norwich, CT 06360-2624 | 2017-06-28 |
| 1861920068 | Mofs-ct Oral Facial Surgery LLC | Dentist | 1 Boulder Ave, Old Greenwich, CT 06870-1420 | 2017-06-01 |
| 1881034262 | Christy Lottinger | Dentist | 263 Farmington Ave # Mc1710, Farmington, CT 06030-1267 | 2013-06-28 |
| 1558618025 | Priceless Dental Care P.C. | Dentist | 60 Waterbury Rd Ste E, Prospect, CT 06712-1251 | 2012-08-14 |
| 1477840270 | Imanuel Babayev | Dentist | 148 East Ave Ste 3h1, Norwalk, CT 06851-5721 | 2011-06-30 |
| 1629364997 | New London Dental Care, LLC | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2011-06-24 |
| 1952600595 | James M. Lee | Dentist | 366 Munger Lane, Bethlehem, CT 06751-1100 | 2011-03-22 |
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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.