CONNECTICUT MAXILLOFACIAL ASSOCIATES P.C. NPI 1174768741

NPI Information

  • NPI: 1174768741
  • Provider Name: CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C.
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Doing Business As: DR. RICHARD BEVILACQUA
  • Address: 71A NAUBUC AVE
    GLASTONBURY, CT
    ZIP 06033
  • Phone: (860) 633-3519

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NPI Details

CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C. is an oral and maxillofacial surgery dentist in Glastonbury, CT. The provider is an oral and maxillofacial surgery dentist specialized in 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. CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C. NPI is 1174768741. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dr. Richard Bevilacqua.

The provider's business location address is:

71A NAUBUC AVE
GLASTONBURY, CT
ZIP 06033-006
Phone: (860) 633-3519
Fax: (860) 633-3510

The provider's authorized official is Richard G Bevilacqua .
The authorized official title is President and has the following contact phone number (860) 633-3519.

The enumeration date for this NPI number is 12/10/2008 and was last updated on 12/30/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery133645CONNECTICUTYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F84844MEDICARE UPINCONNECTICUT

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: 11/21/2025

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