Provider Demographics
NPI:1336471614
Name:STAR DENTAL LLC
Entity Type:Organization
Organization Name:STAR DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARVINDER PAL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-469-5644
Mailing Address - Street 1:300 HEMINGWAY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3000
Mailing Address - Country:US
Mailing Address - Phone:203-469-5644
Mailing Address - Fax:203-469-1067
Practice Address - Street 1:300 HEMINGWAY AVE
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-3000
Practice Address - Country:US
Practice Address - Phone:203-469-5644
Practice Address - Fax:203-469-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008002020Medicaid