Pediatric Dentistry Associates, Llc, NPI 1740334002
Pediatric Dentist in New Haven, CT, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1740334002 |
| NPI Entity Type | Organization |
| Provider Name | Pediatric Dentistry Associates, Llc |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 991 State St, New Haven, CT, US |
| Provider Mailing Address | 991 State St, New Haven, CT, US, 065113993 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | D.M.D. Douglas B. Keck |
| Official Position | OWNER |
| Phone | 203-787-3669 |
Group Taxonomy
| Taxonomy Code | 193400000X |
| Taxonomy Name | 193400000X MULTIPLE SINGLE SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, all of who practice with the same area of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Pediatric Dentist |
| Classification | |
| Group | |
| License No. | 7814 |
| License State | CT |
| Description | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 5525 | CT | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 1184624058 | CT | INDIVIDUAL NPI | 01 |
| 1710988704 | CT | INDIVIDUAL NPI | 01 |
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