BOULDER BROOK DENTAL, LLC (NPI# 1053350470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053350470 |
| Entity Type | Organization |
| Organization Name | BOULDER BROOK DENTAL, LLC |
| Practice Address |
104 Dowd Ct Ludlow MA 01056-1743 |
| Practice Telephone | 4135478085 |
| Practice Fax Number | 4135478085 |
| Mailing Telephone | 4135478085 |
| Mailing Fax Number | 4135478085 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KELLY A CHASE (MBR/OWNER) |
| Authorized Official Telephone | 4135478085 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
17956 | MA | Dental Providers |
| Street Address |
104 DOWD CT |
| City | LUDLOW |
| State | MA |
| Zip Code | 01056-1743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992207997 | Shannon Kurzeski | Nurse Practitioner | 77 Winsor Street - Ludlow Pediatrics, Ludlow, MA 01056 | 2018-03-06 |
| 1811412653 | Melany Ann Picard | Behavior Technician | 87 Ridgeview Circle, Ludlow, MA 01056 | 2017-08-12 |
| 1588981617 | Lindsay Beth Milligan | Physician Assistant | 627 Randall Road, Hampden County Correctional Center, Health Services, Ludlow, MA 01056 | 2010-04-29 |
| 1285874271 | Steve J. Mcdaniel D.d.s. PC | Dentist | 534 Center Street, Ludlow, MA 01056 | 2009-03-03 |
| 1710138813 | Margaret Ann Denby | Nurse Practitioner | 627 Randall Rd., Ludlow, MA 01056 | 2008-10-07 |
| 1285739276 | Pathology Diagnostic Services P.C. | Pathology | 377 Woodland Circle, Ludlow, MA 01056 | 2006-09-14 |
| 1295759876 | Joseph F Wegiel | Dentist | 257 Kendall St, Ludlow, MA 01056 | 2006-07-27 |
| 1972580306 | Lois C Albury | Internal Medicine | 14 Chestnut Place, Ludlow, MA 01056 | 2005-12-28 |
| 1720064983 | Ann Maria Labar Elder | Internal Medicine | 222 State St, Ludlow, MA 01056 | 2005-12-20 |
| 1922094762 | Mohammad U Qayyum | Psychiatry & Neurology | 77 Winsor St, Ste 101, Ludlow, MA 01056 | 2005-09-27 |
| Find all providers in zip 01056 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841665379 | Big Smiles Dental Care | Dentist | 433 Center St, Suite#7, Ludlow, MA 01056-2863 | 2015-12-09 |
| 1285874271 | Steve J. Mcdaniel D.d.s. PC | Dentist | 534 Center Street, Ludlow, MA 01056 | 2009-03-03 |
| 1255504932 | St. Joseph's Family Dental | Dentist | 548 Chapin St, Ludlow, MA 01056-2524 | 2008-04-02 |
| 1619018199 | Daniel Everett Oakes | Dentist | 14 Grettos Gap, Ludlow, VT 05149-9305 | 2007-02-09 |
| 1295759876 | Joseph F Wegiel | Dentist | 257 Kendall St, Ludlow, MA 01056 | 2006-07-27 |
| 1538158266 | David Winsor Manning | Dentist | 653 Center St, Ludlow, MA 01056-1477 | 2005-10-15 |
| 1376835405 | Springfield Medical Care Systems Inc | Dentist | 8 Main St, Ludlow, VT 05149-1106 | 2011-05-09 |
| 1598898553 | Frank J Mitera | Dentist | 257 Kendall St, Ludlow, MA 01056 | 2007-03-13 |
| 1851433262 | John Colburn Montgomery | Dentist | 121 Main St, Ludlow, VT 05149-1025 | 2007-02-13 |
| 1730198516 | Michelle D Roberts | Dentist | 257 Kendall St, Ludlow, MA 01056 | 2006-08-07 |
| Find all providers in LUDLOW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.