LAFAYETTE DENTAL GROUP, PC (NPI# 1699811075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699811075 |
| Entity Type | Organization |
| Organization Name | LAFAYETTE DENTAL GROUP, PC |
| Practice Address |
67 Lafayette St Norwich CT 06360-3407 |
| Mailing Address |
200 Woodland St South Glastonbury CT 06073-2717 |
| Practice Telephone | 8608895213 |
| Practice Fax Number | 8608860100 |
| Mailing Telephone | 8606593450 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID S RICHARDSON (PRESIDENT) |
| Authorized Official Telephone | 8608895213 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
9345 | CT | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
7568 | CT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS CT | 020007568CT03 | 01 |
| CT | ANTHEM BCBS CT | 020009345CT02 | 01 |
| UNITED CONCORDIA | 815896 | 01 | |
| NPI NUMBER ISSUED | 1548343858 | 01 | |
| UNITED CONCORDIA | 1651844 | 01 | |
| UNITED CONCORDIA | 1904629 | 01 |
| Street Address |
67 LAFAYETTE ST |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-3407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548343858 | David S Richardson | Dentist | 67 Lafayette St, Norwich, CT 06360-3407 | 2006-10-23 |
| 1093844920 | Christopher M West | Dentist | 67 Lafayette St, Norwich, CT 06360-3407 | 2007-03-05 |
| 1639257306 | Jason Ryan Campbell | Dentist | 67 Lafayette St, Norwich, CT 06360 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| 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 |
|---|---|---|---|---|
| 1518593896 | Archer Dental Plc | Dentist | 303 Us Route 5 South, Norwich, VT 05055 | 2020-03-18 |
| 1124220173 | David Roger Adams | Dentist | 11 Birdsall St, Norwich, NY 13815-1812 | 2007-06-01 |
| 1528270394 | Richard L. Jorgensen | Dentist | The Eaton Center, 24 Conkey Avenue, Suite 300, Norwich, NY 13815 | 2007-05-04 |
| 1497970081 | James C Gold | Dentist | 3 Waterman Hill Rd, Norwich, VT 05055-9686 | 2007-04-17 |
| 1356408355 | Sami A Yousuf | Dentist | 117 Lafayette St, Norwich, CT 06360-2708 | 2007-01-02 |
| 1972687952 | Linda R Kronick | Dentist | 77 Salem Turnpike, Suite 112, Norwich, CT 06339 | 2006-10-25 |
| 1548343858 | David S Richardson | Dentist | 67 Lafayette St, Norwich, CT 06360-3407 | 2006-10-23 |
| 1902917370 | Matthew D Amaro | Dentist | 17 Lafayette St, Norwich, CT 06360-3407 | 2006-08-31 |
| 1336152941 | Toby P Kravitz | Dentist | 303 Us Route 5 S, Suite 4, Norwich, VT 05055-9508 | 2006-08-14 |
| 1962417402 | Progressive Dental of Norwich, Pllc | Dentist | 101 S Broad St, Norwich, NY 13815-1742 | 2006-07-31 |
| Find all providers in NORWICH | ||||
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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.