Shippan Dental Center

LBN: Shippan Dental Center
Shippan Dental Center is an health care organization with primary practice located at 587 Elm St Shippan Dental Center, Stamford CT 06902-5113. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Shippan Dental Center can be contacted via phone (203) 658-8797, or through Goncharova, Olga via phone (203) 658-8797.

Contact Information

Primary practice address
587 Elm St Shippan Dental Center Stamford CT 06902-5113
Phone: (203) 658-8797
Fax: (203) 355-9837
Website:
Map and Directions
Authorized official contact:
Name: Goncharova, Olga Doctor of Dental Surgery (DDS)
Phone: (203) 658-8797

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8984 Connecticut

Profile Details

NPI number 1063758183
LBN Legal business name Shippan Dental Center
DBA Doing business as
Authorized official Goncharova, Olga Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2012
Last updated Dec 18th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063758183 NPPES
Connecticut MEDICAID 002089846

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