PERIODONTAL ASSOCIATES, LLC (NPI# 1558364091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558364091 |
| Entity Type | Organization |
| Organization Name | PERIODONTAL ASSOCIATES, LLC |
| Practice Address |
61 4th St Stamford CT 06905-5010 |
| Practice Telephone | 2033235900 |
| Mailing Telephone | 2033235900 |
| Enumeration Date | 2005-05-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT CHUNG (MEMBER) |
| Authorized Official Telephone | 2033235900 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
9008 | CT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669710331 | Periodontal Associates, LLC | Dentist | 18753 Sw Martinazzi Ave, Tualatin, OR 97062-6808 | 2013-01-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PERIODONTAL ASSOCIATES, LLC | 18753 Sw Martinazzi Ave, Tualatin, OR 97062 |
| Street Address |
61 4TH ST |
| City | STAMFORD |
| State | CT |
| Zip Code | 06905-5010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710239629 | Joseph Defilippo Dds PC | Dentist | 61 4th St, Stamford, CT 06905-5010 | 2012-10-03 |
| 1902092901 | Allen I. Troy, M.d., P.C. | Orthopaedic Surgery | 61 4th St, Stamford, CT 06905-5010 | 2007-09-24 |
| 1558575704 | Anne Sophie Lebel | Physical Therapist | 61 4th St, Stamford, CT 06905-5010 | 2007-05-09 |
| 1689757064 | Joseph Defilippo Jr. | Dentist | 61 4th St, Stamford, CT 06905-5010 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
| 1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
| 1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
| 1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
| 1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
| 1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
| 1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
| 1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
| 1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
| 1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
| Find all providers in zip 06905 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306940994 | Terence Stewart Jackson | Dentist | 47 Oak St, 2nd Floor, Stamford, CT 06905 | 2006-09-12 |
| 1053328591 | Edmund David D'onofrio | Dentist | 1415 Newfield Ave, Stamford, CT 06905-1415 | 2006-08-01 |
| 1568485035 | Alan Norman Miller | Dentist | 126 Hoyt St, Stamford, CT 06905-5795 | 2006-07-25 |
| 1568655074 | Lisa D Trepp | Dentist | 90 Morgan Street, Suite 305, Stamford, CT 06905 | 2007-08-20 |
| 1508981770 | Miles H Scheffer | Dentist | 90 Morgan St, 305, Stamford, CT 06905 | 2007-03-20 |
| 1417024084 | John Peter Rallo | Dentist | 1081 Hope St, Stamford, CT 06907-1824 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384966 | Connecticut Periodontal & Implant Associates | Dentist | 1080 Day Hill Rd Ste 101, Windsor, CT 06095-1781 | 2020-07-23 |
| 1790212348 | Vidushi Gupta | Dentist | 546 S Broad St Ste 2d, Meriden, CT 06450-6601 | 2017-05-15 |
| 1184057192 | Hamden Family Dental Center | Dentist | 4193 Whitney Ave, Hamden, CT 06518-1212 | 2013-08-13 |
| 1649618901 | Avon Center Dentistry | Dentist | 19 Ensign Drive, Avon, CT 06001 | 2013-06-10 |
| 1487900528 | Amazing Smiles LLC | Dentist | 148 East Ave Ste 1b, Norwalk, CT 06851-5727 | 2012-07-26 |
| 1851614002 | Patricia I Diaz-moreno | Dentist | 263 Farmington Ave # Mc2820, Farmington, CT 06030-2820 | 2010-03-02 |
| 1003045675 | Sejal Thacker | Dentist | 82 Spring Lane, West Hartford, CT 06107 | 2009-07-04 |
| 1013144039 | Stella L. Laskowski | Dentist | 74 Palomba Drive, Enfield, CT 06082 | 2009-06-17 |
| 1407019557 | Nicole Ann Marquis | Dentist | 51 Boston Post Rd, Suite 10, Madison, CT 06443-2155 | 2008-07-09 |
| 1851562466 | Arthur Fred Dean | Dentist | 489 Route 184, Suite 201, Groton, CT 06340-6227 | 2008-03-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PERIODONTAL ASSOCIATES, LLC.
| 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.