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SHIPPAN DENTAL CENTER NPI 1063758183


NPI Information

NPI: 1063758183
Provider Name: SHIPPAN DENTAL CENTER
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
587 ELM ST
SHIPPAN DENTAL CENTER
STAMFORD, CT
ZIP 06902
Phone: (203) 658-8797
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SHIPPAN DENTAL CENTER is a general practice dentist in Stamford, CT. The provider is 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. SHIPPAN DENTAL CENTER NPI is 1063758183. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

587 ELM ST
SHIPPAN DENTAL CENTER
STAMFORD, CT
ZIP 06902-113
Phone: (203) 658-8797
Fax: (203) 355-9837

The provider's authorized official is Olga Goncharova .
The authorized official title is Owner and has the following contact phone number (203) 658-8797.

The enumeration date for this NPI number is 12/18/2012 and was last updated on 12/18/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice8984CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1002089846MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.