DENTAL SERVICES OF SOUTH WINDSOR, LLC (NPI# 1750302980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750302980 |
| Entity Type | Organization |
| Organization Name | DENTAL SERVICES OF SOUTH WINDSOR, LLC |
| Practice Address |
479 Buckland Road South Windsor CT 06074-3515 |
| Mailing Address |
479 Buckland Rd South Windsor CT 06074-3739 |
| Practice Telephone | 8606484471 |
| Practice Fax Number | 8606480181 |
| Mailing Telephone | 8606484471 |
| Mailing Fax Number | 8606480181 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2008-08-18 |
| Authorized Official Name | DR. GREGORY BRUCE HAROIAN (OWNER/MEMBER DENTIST) |
| Authorized Official Telephone | 8602894955 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
9300 | CT | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6350 | CT | Dental Providers |
| Street Address |
479 BUCKLAND ROAD |
| City | SOUTH WINDSOR |
| State | CT |
| Zip Code | 06074-3515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144919 | Russo Therapeutics, LLC | Occupational Therapist | 561 King Street, South Windsor, CT 06074 | 2020-05-04 |
| 1144706631 | Chana Judith Hoagland | Nurse Practitioner | 276 Quarry Brook Drive, South Windsor, CT 06074 | 2018-07-17 |
| 1093203291 | Climb Medical Group LLC | Counselor | 828 Sullivan Ave Ste A, South Windsor, CT 06074 | 2018-04-24 |
| 1528506516 | William P Guinan, Md and Associates LLC | Obstetrics & Gynecology | 25 Oakland Road, South Windsor, CT 06074 | 2017-02-09 |
| 1487027678 | Nadine Caron | Nurse Practitioner | 34 Pleasant Valley Rd, South Windsor, CT 06074 | 2015-11-10 |
| 1275957920 | Ellen Carol Ronsivalli | Dietitian, Registered | 70 High Street, South Windsor, CT 06074 | 2014-02-14 |
| 1881036457 | Chandra Yellinedi | Pharmacist | 55 Frazer Fir, South Windsor, CT 06074 | 2013-07-24 |
| 1144665969 | Brian Thomas Moy | Internal Medicine | 2400 Tamarack Ave Ste 101, South Windsor, CT 06074 | 2013-05-07 |
| 1093072886 | Lydia Lormand | Obstetrics & Gynecology | 2600 Tamarack Ave Ste 200, South Windsor, CT 06074 | 2012-04-18 |
| 1578847307 | International Institute for Professional Development, LLC | Social Worker | 435 Buckland Hills Road, South Windsor, CT 06074 | 2011-09-28 |
| Find all providers in zip 06074 | ||||
| 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 |
|---|---|---|---|---|
| 1790072510 | Zachary T Grillo | Dentist | 498 Buckland Rd, South Windsor, CT 06074-3708 | 2011-06-30 |
| 1457641136 | Evergreen Dental Group, LLC | Dentist | 34 Evergreen Way, South Windsor, CT 06074-6976 | 2011-04-14 |
| 1558550574 | Edmundo R Aquije | Dentist | 469 Buckland Rd., South Windsor, CT 06074 | 2007-10-16 |
| 1740492206 | Douglas Charles Clouser | Dentist | 678 Pleasant Valley Rd, South Windsor, CT 06074-3464 | 2007-05-04 |
| 1700900792 | Kevin Hugo Norige | Dentist | 112 Deming St, South Windsor, CT 06074-3711 | 2007-03-17 |
| 1285643361 | Walter Pierog | Dentist | 866 Foster Street Ext, South Windsor, CT 06074-2116 | 2006-08-06 |
| 1003890443 | Robert J Zatz | Dentist | 1740 Ellington Rd, South Windsor, CT 06074-2768 | 2005-11-30 |
| 1871993766 | Rubin Family Dentistry & Associates, LLC | Dentist | 469 Buckland Rd, South Windsor, CT 06074-3737 | 2014-08-27 |
| 1811270671 | Helen Wong Tang | Dentist | 435 Buckland Rd, South Windsor, CT 06074-3720 | 2011-09-27 |
| 1275829681 | Samuel Li | Dentist | 469 Buckland Rd, South Windsor, CT 06074 | 2011-06-23 |
| Find all providers in SOUTH WINDSOR | ||||
| City | SOUTH WINDSOR |
| Zip Code | 06074 |
Please comment or provide details below to improve the information on DENTAL SERVICES OF SOUTH WINDSOR, 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.