BLOOMFIELD FAMILY DENTAL PC
NPI 1104162890
Dentist - General Practice in Bloomfield, CT
NPI Status: Active since December 27, 2012
Contact Information
2 WINTONBURY MALL
#5
BLOOMFIELD, CT
ZIP 06002
Phone: (860) 656-6941
Fax: (860) 656-6107
- Organization
- Dentist
- General Practice
- CLIA Number: 07D0890278
- CLIA Cert. Type: Ambulance
- CLIA Exp. Date: 08-15-2026
About BLOOMFIELD FAMILY DENTAL PC
This page provides the complete NPI Profile along with additional information for Bloomfield Family Dental Pc, a provider established in Bloomfield, Connecticut operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1104162890 assigned on December 2012. The practitioner's primary taxonomy code is 1223G0001X with license number 009298 (CT). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Shari Mathew (General Dentist)
- NPI
- 1104162890
- Provider Name
- BLOOMFIELD FAMILY DENTAL PC
- Entity Type
- Organization
- Location Address
- 2 WINTONBURY MALL #5 BLOOMFIELD, CT 06002
- Location Phone
- (860) 656-6941
- Location Fax
- (860) 656-6107
- Mailing Address
- 2 WINTONBURY MALL #5 BLOOMFIELD, CT 06002
- Mailing Phone
- (860) 656-6941
- Mailing Fax
- (860) 656-6107
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-27-2012
- Last Update Date
- 03-07-2016
- Code Navigator
A dentist like Bloomfield Family Dental Pc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 009298
- License State
- CT
- Taxonomy Description
- A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1962684415 | MEDICAID (05) | CT |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D0890278
- Facility Type
- Ambulance
- Certificate Effective Date
- August 16, 2024
- Certificate Expiration Date
- August 15, 2026
- Laboratory Director
- ELLEN R. WHITE SGT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Bloomfield Family Dental Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104162890, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
BLOOMFIELD, CT 06002
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104162890, enumerated as an "organization" on December 27, 2012.
The provider is located at 2 WINTONBURY MALL #5 BLOOMFIELD, CT 06002 and the phone number is (860) 656-6941.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
