DR.DENTAL OF DERBY P.C. (NPI# 1912249517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912249517 |
| Entity Type | Organization |
| Organization Name | DR.DENTAL OF DERBY P.C. |
| Practice Address |
49 Pershing Dr Derby CT 06418-1406 |
| Practice Telephone | 2017250372 |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-07-05 |
| Authorized Official Name | ARTHUR REVECHKIS (MANAGING DIRECTOR) |
| Authorized Official Telephone | 2017250372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
010025 | CT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 010025 | 05 |
| Street Address |
49 PERSHING DR |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497018 | Valley Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 49 Pershing Dr, Derby, CT 06418-1406 | 2005-06-15 |
| 1669086575 | Longqian Wang | Dentist | 49 Pershing Dr, Derby, CT 06418-1406 | 2020-09-08 |
| 1588128235 | Anurag Bhargava | Dentist | 49 Pershing Dr, Derby, CT 06418-1406 | 2019-01-28 |
| 1669956124 | Silvena Petrova | Pharmacist | 49 Pershing Dr, Derby, CT 06418-1406 | 2018-09-20 |
| 1235611971 | David Andrejecsk | Pharmacist | 49 Pershing Dr, Derby, CT 06418-1406 | 2018-08-29 |
| 1437471653 | Liberty Health Supplies LLC | Durable Medical Equipment & Medical Supplies | 49 Pershing Dr, Derby, CT 06418-1437 | 2010-02-16 |
| 1548311848 | Grade A Market Derby LLC | Durable Medical Equipment & Medical Supplies | 49 Pershing Dr, Derby, CT 06418-1406 | 2007-01-15 |
| 1417051608 | Valley Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 49 Pershing Dr, Derby, CT 06418 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
| Find all providers in zip 06418 | ||||
| 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 |
|---|---|---|---|---|
| 1033661988 | Dental Professionals LLC | Dentist | 900 E Meadowlark Blvd, Derby, KS 67037-3465 | 2016-10-26 |
| 1417222993 | Midwest Dental Kansas Derby Pa | Dentist | 1700 E James St, Derby, KS 67037-3543 | 2012-03-15 |
| 1699901595 | Frederick Wayne Stark | Dentist | 1710 E Madison Ave Ste 600, Derby, KS 67037-2285 | 2009-06-05 |
| 1427241058 | Jay F. Clark | Dentist | 7455 Erie Rd, Lake Shore Prof Bldg, Derby, NY 14047-9305 | 2007-08-27 |
| 1063553964 | Anita Dugatto-coscia | Dentist | 69 Elizabeth St, 2nd Floor, Derby, CT 06418-1825 | 2007-02-12 |
| 1639218902 | Aaron Reilender D.d.s., Pa | Dentist | 1710 E Madison Ave, Suite 600, Derby, KS 67037-2189 | 2007-02-05 |
| 1619069614 | Bradley K Skillen | Dentist | 1700 James St, Derby, KS 67037-3543 | 2006-09-28 |
| 1417929035 | Christopher J Hickerson | Dentist | 1120 N Rock Rd, Suite 100, Derby, KS 67037-3584 | 2006-02-07 |
| 1740265800 | Vincent Thomas Farha | Dentist | 500 North Georgie Ave, Derby, KS 67037-1707 | 2005-12-13 |
| 1770586935 | Steven Frances Rospond | Dentist | 620 N Georgie Ave, Derby, KS 67037-1724 | 2005-05-23 |
| Find all providers in DERBY | ||||
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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.