BLUE BACK DENTAL LLC
NPI 1174814495
Dentist - General Practice in West Hartford, CT

Active since April 20, 2011
65 MEMORIAL RD STE 400, WEST HARTFORD, CT 06107(860) 233-9300(860) 233-9304 Get Directions Write a Review

NPPES record last updated: April 20, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Blue Back Dental Llc NPPES

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

BLUE BACK DENTAL LLC (NPI 1174814495) is a healthcare organization registered as a general practice in West Hartford, Connecticut and active in the NPI registry since April 2011. The organization lists Kirsten E Capozzi, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1174814495
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBLUE BACK DENTAL LLC
Location Address65 MEMORIAL RD STE 400West Hartford, CT 06107-4219
Mailing Address65 Memorial Rd Ste 400West Hartford, CT 06107-4219 · (860) 233-9300 · Fax (860) 233-9304
Fax(860) 233-9304
Organization SubpartNo
Authorized OfficialKirsten E CapozziPractice Manager · (860) 233-9300
Enumeration DateApril 20, 2011
NPI 1174814495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses Licensed in CT · 5904 Licensed in CT · 8915
Definition
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.
Also ListedDentist · PeriodonticsTaxonomy 1223P0300X · License 5407 (CT)
65 MEMORIAL RD STE 400, West Hartford, CT 06107

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Back Dental LLC's NPI number?

The NPI number for Blue Back Dental LLC is 1174814495. It was assigned to this organization in the NPPES registry on April 20, 2011.

Where is Blue Back Dental LLC located?

Blue Back Dental LLC is located at 65 Memorial Rd Ste 400, West Hartford, CT 06107. The listed phone number is (860) 233-9300.

What is Blue Back Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Blue Back Dental LLC was last updated on April 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.