CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC
NPI 1053782060
Clinic/Center - Oral and Maxillofacial Surgery in West Hartford, CT

Active since October 16, 2015
80 S MAIN ST, WEST HARTFORD, CT 06107(860) 231-1030(860) 231-1032 Get Directions Write a Review

NPPES record last updated: October 17, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 17, 2022, Nov 23, 2015 (2 updates tracked since 2015).

About Connecticut Center For Oral Facial And Implant Surgery Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC (NPI 1053782060) is a healthcare organization registered as an oral and maxillofacial surgery in West Hartford, Connecticut and active in the NPI registry since October 2015. The organization lists Jacob Marshall Gady, President, as its authorized official.

NPPES Registry Identity

NPI1053782060
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameCONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC
Location Address80 S MAIN STWest Hartford, CT 06107-2408
Mailing Address80 S Main StWest Hartford, CT 06107-2408 · (860) 231-1030 · Fax (860) 231-1032
Fax(860) 231-1032
Organization SubpartNo
Authorized OfficialJacob Marshall GadyPresident · (860) 231-1030
Enumeration DateOctober 16, 2015
Last NPPES UpdateOctober 17, 20222 updates tracked since enumeration
NPPES CertifiedJuly 7, 2022
NPI 1053782060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
License Licensed in CT · 011331
Definition

An oral and maxillofacial surgery clinic or center 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.

80 S MAIN ST, West Hartford, CT 06107

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Oral and Maxillofacial Surgery)
80 S MAIN ST
WEST HARTFORD, CT 06107
Dentist
80 S MAIN ST
WEST HARTFORD, CT 06107
Dentist
80 S MAIN ST
WEST HARTFORD, CT 06107

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053782060, enumerated as an "organization" on October 16, 2015.

The provider is located at 80 S MAIN ST WEST HARTFORD, CT 06107 and the phone number is (860) 231-1030.

Clinic/Center with taxonomy code 261QS0112X and a focus in Oral and Maxillofacial Surgery.