PREMIER DENTAL P C (NPI# 1710394903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710394903 |
| Entity Type | Organization |
| Organization Name | PREMIER DENTAL P C |
| Practice Address |
727 Broad St Meriden CT 06450-4341 |
| Practice Telephone | 2032351415 |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | POLINA P SIMANOVICH (DENTIST/PROSTHODONTIST) |
| Authorized Official Telephone | 2032351415 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
10452 | CT | Dental Providers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | PTAN MEDICARE NSC | 7807300001 | 01 |
| Street Address |
727 BROAD ST |
| City | MERIDEN |
| State | CT |
| Zip Code | 06450-4341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447294087 | James Clarke | Dentist | 727 Broad St, Meriden, CT 06450-4341 | 2006-06-15 |
| 1770743171 | Polina P Simanovich | Dentist | 727 Broad St, Meriden, CT 06450-4341 | 2008-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861056525 | Oak Counseling Services LLC | Counselor | Oak Counseling Services, LLC, 97 East Main St. (suite 1h), Meriden, CT 06450 | 2019-04-29 |
| 1467969253 | Midstate Arc | Day Training, Developmentally Disabled Services | 200 Research Pkwy, Meriden, CT 06450 | 2018-01-03 |
| 1144674672 | Felistas Mazhandu | Nurse Practitioner | 53 Church Hill Chase, Meriden, CT 06450 | 2016-04-21 |
| 1639557390 | D J Park PC | Dentist | 490-19 South Broad Street, Meriden, CT 06450 | 2015-05-14 |
| 1912393844 | Elliott Lacki | Psychologist | 1355 N Broad St, Meriden, CT 06450 | 2015-04-07 |
| 1124379797 | Jamie Anne Gargano | Social Worker | 538 Preston Avenue, Meriden, CT 06450 | 2012-09-24 |
| 1760738025 | Psychologist Adriana L Gonzalez Phd Pllc | Clinic/Center | 85 Hillcrest Terrace, Meriden, CT 06450 | 2012-07-24 |
| 1174888622 | Dong Jin Park | Dentist | 490 S Broad St, Meriden, CT 06450 | 2012-07-11 |
| 1710253182 | Adriana Laura Gonzalez | Psychologist | 85 Hillcrest Ter, Meriden, CT 06450 | 2012-03-29 |
| 1285864199 | Crystal Ann Herdman | Occupational Therapist | 33 Cone Avenue, Meriden, CT 06450 | 2009-07-27 |
| Find all providers in zip 06450 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790338978 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 455 Lewis Ave Ste 210, Meriden, CT 06451-2121 | 2019-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275148207 | Rom Technologies, Inc. | Durable Medical Equipment & Medical Supplies | 559b Federal Rd Unit 1-3, Brookfield, CT 06804-2800 | 2020-09-15 |
| 1629621891 | Hartford Healthcare Medical Group Specialists LLC | Durable Medical Equipment & Medical Supplies | 65 Memorial Rd Ste 430, West Hartford, CT 06107-4220 | 2019-07-17 |
| 1740794445 | Dental Sleep Medicine of Central Connecticut, LLC | Durable Medical Equipment & Medical Supplies | 955 S Main St Ste B, Middletown, CT 06457-5153 | 2017-11-17 |
| 1518351311 | Next Health LLC | Durable Medical Equipment & Medical Supplies | 300 Wilson Ave, Norwalk, CT 06854-4663 | 2015-03-19 |
| 1821303868 | Sequese Lacole Arline | Durable Medical Equipment & Medical Supplies | 15 Walker Ln, Bloomfield, CT 06002-2853 | 2010-08-14 |
| 1801051651 | Freedom Lifts LLC | Durable Medical Equipment & Medical Supplies | 854 Providence Pike, Danielson, CT 06239-3901 | 2008-07-22 |
| 1518124650 | Vidacura, Inc. | Durable Medical Equipment & Medical Supplies | 169 Hilltop Dr, Southington, CT 06489-2422 | 2008-05-16 |
| 1013053800 | Praxair Healthcare Services Inc | Durable Medical Equipment & Medical Supplies | 2 Oakwood Ave, Norwalk, CT 06850-1318 | 2007-01-29 |
| 1144381294 | The Morgan Group LLC | Durable Medical Equipment & Medical Supplies | 380 W Hill Rd, New Hartford, CT 06057-2415 | 2006-12-13 |
| 1013966209 | Conti Orthopedic Appliance, Inc. | Durable Medical Equipment & Medical Supplies | 1040 Route 80, Guilford, CT 06437-1212 | 2006-05-08 |
| 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.