Provider Demographics
NPI:1588752828
Name:SOUNDENTAL ASSOC P.C.
Entity type:Organization
Organization Name:SOUNDENTAL ASSOC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHMOND
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-932-5818
Mailing Address - Street 1:655 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516
Mailing Address - Country:US
Mailing Address - Phone:203-932-5818
Mailing Address - Fax:203-933-6432
Practice Address - Street 1:655 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-932-5818
Practice Address - Fax:203-933-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
CT44281223G0001X
CT43661223G0001X
CT94561223G0001X
CT84881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004397344Medicaid