Healthcare Provider Details

I. General information

NPI: 1801786801
Provider Name (Legal Business Name): NEWBURY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 FEDERAL RD STE C25
BROOKFIELD CT
06804-2647
US

IV. Provider business mailing address

246 FEDERAL RD STE C25
BROOKFIELD CT
06804-2647
US

V. Phone/Fax

Practice location:
  • Phone: 203-740-1334
  • Fax:
Mailing address:
  • Phone: 203-740-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUITA VANESSA CASTRO
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 203-740-1334