Provider Demographics
NPI:1548530512
Name:GLOBUS DENTAL NEWINGTON CORP
Entity type:Organization
Organization Name:GLOBUS DENTAL NEWINGTON CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANGANAYAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRUMAMILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-223-2000
Mailing Address - Street 1:3001 BERLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-4601
Mailing Address - Country:US
Mailing Address - Phone:860-223-2000
Mailing Address - Fax:
Practice Address - Street 1:3001 BERLIN TPKE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-4601
Practice Address - Country:US
Practice Address - Phone:860-223-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty