CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC – NPI #1053782060
Clinic/Center

The specialty of dentistry which includes 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.

Health Care Provider Taxonomy Code for Clinic/Center

CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC is an AHC clinic located in WEST HARTFORD, CT. NPPES has assigned the NPI number 1053782060 to CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC on October 16, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QS0112X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Oral and Maxillofacial Surgery

The NPI profile was previously updated about 4 years ago on Oct 17, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC below.

NPI Profile for
CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC

NPI Number
1053782060
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC
Primary location
80 S MAIN ST
WEST HARTFORD, CT 06107-2408
Phone: (860) 231-1030 Fax: (860) 231-1032
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JACOB GADY
PRESIDENT
Phone: (860) 231-1030
Updated
Certification Date
Jul 07, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QS0112X
- Clinic/Center / Oral and Maxillofacial Surgery (Primary)		 CT 011331

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.