Individual provider · Type 1 NPI
Mitra Marvasti-Sitterly
Pediatric Dentistry · Weatogue, CT
NPI number
1154065514
Active
Practice location
381 Hopmeadow St Ste 202
Weatogue, CT 06089-9697
Mailing address
181 Partridge Lndg
Glastonbury, CT 06033-2849
Other practice locations
- 21 Bay State Rd, Chicopee, MA 01020-1521 · (860) 692-8127
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1859415 (MA) |
| General Practice Dentistry | 1223G0001X | 13636 (CT) |
| Pediatric Dentistry | 1223P0221X | DN1859415 (MA) |
| Student in an Organized Health Care Education/Training Program | 390200000X | 13758 (CT) |
| Pediatric Dentistry Primary | 1223P0221X | 13636 (CT) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Another provider at this address
Other pediatric dentistry providers in Weatogue
About NPI 1154065514
Mitra Marvasti-Sitterly's National Provider Identifier is 1154065514, issued on Apr 22, 2022. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Weatogue, CT. The record was last updated on Jun 25, 2025.