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LIGHTHOUSE DENTAL CARE LLC NPI 1427258300


NPI Information

NPI: 1427258300
Provider Name: LIGHTHOUSE DENTAL CARE, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
88 RYDERS LN
STRATFORD, CT
ZIP 06614
Phone: (203) 378-1566
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LIGHTHOUSE DENTAL CARE, LLC is a general practice dentist in Stratford, 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. LIGHTHOUSE DENTAL CARE, LLC NPI is 1427258300. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

88 RYDERS LN
STRATFORD, CT
ZIP 06614-666
Phone: (203) 378-1566
Fax: (203) 380-8390

The provider's authorized official is Mark Samuels .
The authorized official title is Owner and has the following contact phone number (203) 378-1566.

The enumeration date for this NPI number is 7/19/2007 and was last updated on 4/7/2014.


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 Practice6758CONNECTICUTYes

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
17003750001MEDICARE NSCCONNECTICUT

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

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