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PARK STREET FAMILY DENTAL
NPI 1518234079
Dentist - General Practice in Hartford, CT

Active since November 28, 2011
454 PARK ST, HARTFORD, CT 06106(860) 944-2802 Get Directions Write a Review

NPPES record last updated: November 28, 2011. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Park Street Family Dental NPPES

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

PARK STREET FAMILY DENTAL (NPI 1518234079) is a healthcare organization registered as a general practice in Hartford, Connecticut and active in the NPI registry since November 2011. The organization lists Krishnaprasanth Mudusu, Owner, as its authorized official.

NPPES Registry Identity

NPI1518234079
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePARK STREET FAMILY DENTAL
Location Address454 PARK STHartford, CT 06106-1525
Mailing Address454 Park StHartford, CT 06106-1525 · (860) 944-2802
Phone(860) 944-2802
Organization SubpartNo
Authorized OfficialKrishnaprasanth MudusuOwner · (860) 944-2802
Enumeration DateNovember 28, 2011
✔ NPI 1518234079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CT · 010554
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.
454 PARK ST, Hartford, CT 06106
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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

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 Park Street Family Dental's NPI number?

The NPI number for Park Street Family Dental is 1518234079. It was assigned to this organization in the NPPES registry on November 28, 2011.

Where is Park Street Family Dental located?

Park Street Family Dental is located at 454 Park St, Hartford, CT 06106. The listed phone number is (860) 944-2802.

What is Park Street Family Dental'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 Park Street Family Dental was last updated on November 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.