MOFS-CT ORAL FACIAL SURGERY LLC (NPI# 1861920068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861920068 |
| Entity Type | Organization |
| Organization Name | MOFS-CT ORAL FACIAL SURGERY LLC |
| Other Organization Name | DENTAL ORAL SURGERY |
| Practice Address |
1 Boulder Ave Old Greenwich CT 06870-1420 |
| Mailing Address |
6118 Riverdale Ave Bronx NY 10471-1009 |
| Practice Telephone | 2039903300 |
| Practice Fax Number | 2122026447 |
| Mailing Telephone | 2039987470 |
| Mailing Fax Number | 2122026447 |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2017-06-01 |
| Authorized Official Name | DR. JANET C BODEY (MANAGING MEMBER) |
| Authorized Official Telephone | 2039987470 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9973 | CT | Dental Providers |
| Other Name | Type Code |
|---|---|
| Dental Oral Surgery | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MOFS-CT ORAL FACIAL SURGERY LLC | 1336 E. Putnam Ave., (1 Boulder Ave.), Greenwich, CT 06870 |
| Street Address |
1 BOULDER AVE |
| City | OLD GREENWICH |
| State | CT |
| Zip Code | 06870-1420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033654389 | Hannah Noel Smith | Social Worker | 1445 E Putnam Ave Ste 1, Old Greenwich, CT 06870 | 2016-12-22 |
| 1386191864 | Priscilla J Whittington | Personal Emergency Response Attendant | 1336 East Putnam Ave, Old Greenwich, CT 06870 | 2016-09-01 |
| 1457778193 | Advanced Ophthalmology of Connecticut LLC | Ophthalmology | 1455 East Putnam Avenue, Old Greenwich, CT 06870 | 2014-03-19 |
| 1225370422 | The Greenwich Medical Skincare and Laser Spa | Clinic/Center | 1345 E. Putnam Ave, The Greenwich Medical Skincare and Laser Spa, Old Greenwich, CT 06870 | 2013-03-26 |
| 1033430251 | Alona Altman | Speech-Language Pathologist | 27 Macarthur Dr., Old Greenwich, CT 06870 | 2010-06-22 |
| 1023344462 | Sarah Kate Leahey | Speech-Language Pathologist | 56 Havemeyer Lane, Old Greenwich, CT 06870 | 2009-10-20 |
| 1033345574 | Mary Ellen Foulds Lorefice | Social Worker | 39 Ballwood Road, Old Greenwich, CT 06870 | 2009-06-10 |
| 1215151204 | Nelly Tsivina | Acupuncturist | 13 Arcadia Rd, Suite #9, Old Greenwich, CT 06870 | 2007-04-12 |
| 1568580645 | Abilis Inc | Intermediate Care Facility, Mentally Retarded | 15 Cross Ridge, Garc, Old Greenwich, CT 06870 | 2007-03-27 |
| 1588702559 | Edward J Mamelok | Technician/Technologist | 15 Arcadia Road, Old Greenwich, CT 06870 | 2007-02-02 |
| Find all providers in zip 06870 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053951350 | Connecticut Oral Surgery and Implant Center, Pllc | Dentist | 314 Flanders Rd Ste 1b, East Lyme, CT 06333-1727 | 2020-01-14 |
| 1952898025 | Premier Oral Surgery and Implantology Center LLC | Dentist | 411 Barnum Avenue Cutoff Ste 5, Stratford, CT 06614-5100 | 2018-04-15 |
| 1629595145 | Gary Fishbein Dmd LLC | Dentist | 281 Hartford Tpke Ste 307, Vernon, CT 06066-4707 | 2017-08-25 |
| 1912428160 | Gm Surgical Associates LLC | Dentist | 130 New London Tpke Ste 3, Norwich, CT 06360-2624 | 2017-06-28 |
| 1881034262 | Christy Lottinger | Dentist | 263 Farmington Ave # Mc1710, Farmington, CT 06030-1267 | 2013-06-28 |
| 1558618025 | Priceless Dental Care P.C. | Dentist | 60 Waterbury Rd Ste E, Prospect, CT 06712-1251 | 2012-08-14 |
| 1477840270 | Imanuel Babayev | Dentist | 148 East Ave Ste 3h1, Norwalk, CT 06851-5721 | 2011-06-30 |
| 1629364997 | New London Dental Care, LLC | Dentist | 258 S Frontage Rd, New London, CT 06320-2641 | 2011-06-24 |
| 1952600595 | James M. Lee | Dentist | 366 Munger Lane, Bethlehem, CT 06751-1100 | 2011-03-22 |
| 1366671281 | Simon Bangiyev | Dentist | 346 Main Ave Ste H, Norwalk, CT 06851-1592 | 2009-07-13 |
| Find all providers with the same taxonomy | ||||
| City | OLD GREENWICH |
| Zip Code | 06870 |
Please comment or provide details below to improve the information on MOFS-CT ORAL FACIAL SURGERY 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.