FAMILY DENTISTRY OF BRIDGEPORT P.C. (NPI# 1124308184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124308184 |
| Entity Type | Organization |
| Organization Name | FAMILY DENTISTRY OF BRIDGEPORT P.C. |
| Practice Address |
90 Brooklawn Ave Bridgeport CT 06604-2010 |
| Practice Telephone | 2033344837 |
| Mailing Telephone | 2033344837 |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2011-08-23 |
| Authorized Official Name | DR. MARK AGABABAEV (PRESIDENT) |
| Authorized Official Telephone | 7188871397 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
010091 | CT | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Family Dentistry of Bridgeport P. C. | 90 Brooklawn Ave, Bridgeport, CT 06604 |
| Street Address |
90 BROOKLAWN AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06604-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114462454 | Ginag Health Home Care LLC | Home Health | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2016-12-22 |
| 1730530577 | Tatiana Agababaeva | Dentist | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2016-06-23 |
| 1730595380 | Ivan Makar | Dentist | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2014-07-03 |
| 1871863613 | Tetyana Pohorletska Andassociates, Inc. | Dentist | 90 Brooklawn Ave, Bridgeport, CT 06604-2010 | 2012-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
| 1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
| 1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
| 1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
| 1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
| 1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| Find all providers in zip 06604 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1609199074 | Sph Enterprise LLC | Dentist | 161 Boston Ave, Bridgeport, CT 06610-1662 | 2010-03-12 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06604 |
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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.