Healthcare Provider Details

I. General information

NPI: 1396669560
Provider Name (Legal Business Name): ASPIRE FAMILY DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 TOWN LINE RD
WETHERSFIELD CT
06109-4352
US

IV. Provider business mailing address

55 TOWN LINE RD
WETHERSFIELD CT
06109-4352
US

V. Phone/Fax

Practice location:
  • Phone: 860-529-5280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: NAYAKI GADDIPATI
Title or Position: OWNER
Credential: DMD
Phone: 214-336-9767