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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: July 19, 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
Phone(860) 233-9300
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
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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

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Frequently Asked Questions

What is BLUE BACK DENTAL LLC's NPI number?

The NPI number assigned to this healthcare provider is 1174814495, enumerated as an "organization" on April 20, 2011.

Where is the provider located?

The provider is located at 65 MEMORIAL RD STE 400 WEST HARTFORD, CT 06107 and the phone number is (860) 233-9300.

What is the provider's specialty?

Dentist with taxonomy code 1223G0001X and a focus in General Practice.