MADISON DENTAL SPA (NPI# 1790343051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790343051 |
| Entity Type | Organization |
| Organization Name | MADISON DENTAL SPA |
| Practice Address |
90 Wall St Ste 100 Madison CT 06443-3128 |
| Practice Telephone | 2032455101 |
| Practice Fax Number | 2032455121 |
| Mailing Telephone | 2032455101 |
| Mailing Fax Number | 2032455121 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |
| Authorized Official Name | DR. MOUMEN ALMOUZAYN (DENTIST) |
| Authorized Official Telephone | 2032455121 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Madison Dental Spa | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 90 Wall St Ste 100, Madison, CT 064433128 | 2032455101 | 2032455121 |
| Street Address |
90 WALL ST STE 100 |
| City | MADISON |
| State | CT |
| Zip Code | 06443-3128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194127506 | Heather R. Clinton | Social Worker | 847 West Main Street, Suite 3, Branford, CT 06443 | 2014-09-17 |
| 1477973378 | Katrina Louise Furey | Psychiatry & Neurology | 147 Durham Rd Ste 12a-ne, Madison, CT 06443 | 2014-04-18 |
| 1972920114 | Elizabeth Laberee | Internal Medicine | 80 Devonshire Lane, Madison, CT 06443 | 2014-03-26 |
| 1588007314 | Avery Grauer | Psychiatry & Neurology | 175 Copse Road, Madison, CT 06443 | 2013-04-11 |
| 1295077790 | Gordon Seth Cohen | Pathology | 3 Silo Hill Road, Madison, CT 06443 | 2013-03-22 |
| 1073750493 | Darlene F. Talavera | Occupational Therapist | 22 Overshore Drive, Madison, CT 06443 | 2009-01-08 |
| 1013182518 | Susan Jean Isaac | Social Worker | 105 Winding Road, Unit 2, Madison, CT 06443 | 2008-04-25 |
| 1083893606 | Kornelia Keszler, Md, PC | Internal Medicine | 1-b Meigswood Ave, Madison, CT 06443 | 2007-10-31 |
| 1811181126 | Traci Marando | Nurse Practitioner | 20 Madrina Lane, Madison, CT 06443 | 2007-08-29 |
| 1790803419 | Linda L. Young | Social Worker | 2 Samson Rock Drive, Unit 2g, Madison, CT 06443 | 2007-03-27 |
| Find all providers in zip 06443 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306301072 | Dr. Lee Gus Dunker | Clinic/Center | 424 West St, Madison, IN 47250-3302 | 2019-02-06 |
| 1518422880 | Bright Dental Madison LLC | Clinic/Center | 7866 Mineral Point Rd, Madison, WI 53717-2028 | 2019-01-31 |
| 1992217053 | Great Day Dental of Monona | Clinic/Center | 2010 Eastwood Dr Ste 206, Madison, WI 53704-5387 | 2017-10-30 |
| 1770913220 | L.l. Barnett Dental Solutions, P.C. | Clinic/Center | 7185 Highway 72 W Ste C, Madison, AL 35758-6650 | 2013-11-20 |
| 1114210481 | Abcom Family Dental Care | Clinic/Center | 5402 Mineral Point Rd, Madison, WI 53705-4659 | 2011-05-19 |
| 1790976553 | Dr Andrew D Friedman Dmd | Clinic/Center | 21 Old Point Ave, Madison, ME 04950-1114 | 2007-08-07 |
| 1235351750 | Madison Dental Care | Clinic/Center | 535 Gallatin Pike S, Madison, TN 37115-4010 | 2007-05-03 |
| 1386209849 | Southeastern Dental Pllc | Clinic/Center | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2019-05-09 |
| 1417421421 | Kevin L. Klinedinst Dds PC | Clinic/Center | 110 Miles Ridge Rd, Madison, IN 47250-2410 | 2019-01-14 |
| 1417476458 | Madison Dental LLC | Clinic/Center | 2110 Fordem Ave, Madison, WI 53704-4610 | 2017-09-11 |
| Find all providers in MADISON | ||||
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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.