Healthcare Provider Details

I. General information

NPI: 1598646770
Provider Name (Legal Business Name): DENTAL SEDATION CENTER OF CONNECTICUT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 KINGS HWY E
FAIRFIELD CT
06825-4867
US

IV. Provider business mailing address

501 KINGS HWY E
FAIRFIELD CT
06825-4867
US

V. Phone/Fax

Practice location:
  • Phone: 860-561-1233
  • Fax: 203-306-3019
Mailing address:
  • Phone: 860-561-1233
  • Fax: 203-306-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SETH R PODOLSKY
Title or Position: OWNER
Credential: MD
Phone: 860-561-1233