DR. RICHARD J SHANAHAN (NPI# 1023008893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023008893 |
| Entity Type | Individual |
| Full Name | DR. RICHARD J SHANAHAN |
| Credential | DDS PC |
| Practice Address |
109 Watertown Ave Waterbury CT 06708-2623 |
| Practice Telephone | 2037547100 |
| Practice Fax Number | 2037547822 |
| Mailing Telephone | 2037547100 |
| Mailing Fax Number | 2037547822 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
03101 | CT | Dental Providers |
| Street Address |
109 WATERTOWN AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578818191 | Pradipta Mazumder | Dentist | 109 Watertown Ave, Waterbury, CT 06708-2623 | 2012-07-19 |
| 1629101332 | Joseph F Verzino | Dentist | 109 Watertown Ave, Waterbury, CT 06708-2623 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912394834 | Connecticut Smiles LLC | Dentist | 109 Watertown Ave Ste 1, Waterbury, CT 06708-2623 | 2015-04-17 |
| 1801927454 | Bruce Seth Gottlieb | Dentist | 255 Robbins St, Waterbury, CT 06708-2752 | 2007-03-07 |
| 1396157475 | Natalia Sanchez Menjivar | Dentist | 650 Chase Pkwy, Waterbury, CT 06708-3046 | 2014-05-23 |
| 1578818191 | Pradipta Mazumder | Dentist | 109 Watertown Ave, Waterbury, CT 06708-2623 | 2012-07-19 |
| 1437379260 | Ronald P. Ritucci Dmd PC | Dentist | 650 Chase Pkwy, Waterbury, CT 06708-3040 | 2007-04-26 |
| 1538218920 | Michael Lawrence Friedman | Dentist | 650 Chase Pkwy, Waterbury, CT 06708-3040 | 2007-01-09 |
| 1568412195 | Ronald Paul Ritucci | Dentist | 650 Chase Pkwy, Waterbury, CT 06708-3040 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894831 | Chia-hua Pai | Dentist | 10 Mott Ave Ste 3c, Norwalk, CT 06850-3320 | 2020-09-04 |
| 1699307819 | Michael Fogge | Dentist | 1527 Route 12 Ste 2, Gales Ferry, CT 06335-1800 | 2020-02-05 |
| 1033752613 | Gregory Augustus Mckenna | Dentist | 131 Deer Hill Ave, Danbury, CT 06810-7783 | 2019-10-25 |
| 1760024723 | Baliram Maraj | Dentist | 801 Plainville Ave., Farmington, CT 06032 | 2019-10-11 |
| 1700379765 | Emily Ding | Dentist | 241 Monroe Tpke, Monroe, CT 06468 | 2018-06-13 |
| 1568978476 | Modern Orthodontics LLC | Dentist | 1095 West St Ste 2, Southington, CT 06489-1023 | 2017-12-15 |
| 1568991636 | Bibko Orthodontics LLC | Dentist | 346 Main Ave Ste D, Norwalk, CT 06851-1591 | 2017-06-12 |
| 1114467164 | Consolidated Orthodontic Services, LLC | Dentist | 3 Silver Brook Ln, Torrington, CT 06790-7814 | 2017-02-23 |
| 1922544543 | Raptis Orthodontics | Dentist | 670 East Rd, Bristol, CT 06010-6845 | 2017-01-07 |
| 1538604178 | Donald C Demas, Dds, Ms, PC | Dentist | 51 Depot St Ste 505, Watertown, CT 06795-2685 | 2017-01-05 |
| Find all providers with the same taxonomy | ||||
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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.