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PEDIATRIC DENTAL ASSOCIATES OF SOUTHBURY LLC
NPI 1629225875
Dentist - Pediatric Dentistry in Southbury, CT

Active since August 19, 2008
1 POMPERAUG OFFICE PARK, SUITE 206, SOUTHBURY, CT 06488(203) 264-1497(203) 264-4039 Get Directions Write a Review

NPPES record last updated: August 19, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Dental Associates Of Southbury Llc NPPES

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

PEDIATRIC DENTAL ASSOCIATES OF SOUTHBURY LLC (NPI 1629225875) is a healthcare organization registered as a pediatric dentistry in Southbury, Connecticut and active in the NPI registry since August 2008. The organization lists Marguerite C Gillette, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1629225875
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePEDIATRIC DENTAL ASSOCIATES OF SOUTHBURY LLC
Location Address1 POMPERAUG OFFICE PARK, SUITE 206Southbury, CT 06488-2295
Mailing Address1 Pomperaug Office Park, Suite 206Southbury, CT 06488-2295 · (203) 264-1497 · Fax (203) 264-4039
Phone(203) 264-1497
Fax(203) 264-4039
Organization SubpartNo
Authorized OfficialMarguerite C GilletteOffice Manager · (203) 264-1497
Enumeration DateAugust 19, 2008
✔ NPI 1629225875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in CT · 007834
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
1 POMPERAUG OFFICE PARK, Southbury, CT 06488
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Other Identifiers 1

Medicaid008001055CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

ANTONIO LEPORE D.D.S.
Dentist (Pediatric Dentistry)
1 POMPERAUG OFFICE PARK, SUITE 206
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 264-1497
DR. ANNMARIE DELESSIO-MATTA D.M.D.
Dentist (Pediatric Dentistry)
1 POMPERAUG OFFICE PARK, SUITE 206
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 264-1497
ODIN DE LOS REYES DPM INC
Podiatrist (Primary Podiatric Medicine)
1 POMPERAUG OFFICE PARK, SUITE 105
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (230) 262-6100
DR. RICHARD NICHOLAS BIONDI M.D.
Internal Medicine
1 POMPERAUG OFFICE PARK, SUITE 202
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 264-3130
ODIN DELOS REYES D.P.M
Podiatrist (Primary Podiatric Medicine)
1 POMPERAUG OFFICE PARK, SUITE 105
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 262-6100

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 Pediatric Dental Associates Of Southbury LLC's NPI number?

The NPI number for Pediatric Dental Associates Of Southbury LLC is 1629225875. It was assigned to this organization in the NPPES registry on August 19, 2008.

Where is Pediatric Dental Associates Of Southbury LLC located?

Pediatric Dental Associates Of Southbury LLC is located at 1 Pomperaug Office Park Suite 206, Southbury, CT 06488. The listed phone number is (203) 264-1497.

What is Pediatric Dental Associates Of Southbury LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Pediatric Dental Associates Of Southbury LLC was last updated on August 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.