RELIANT DENTAL GROUP PC (NPI# 1104399443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104399443 |
| Entity Type | Organization |
| Organization Name | RELIANT DENTAL GROUP PC |
| Practice Address |
1996 Centre St Ste 201 West Roxbury MA 02132-3330 |
| Practice Telephone | 6172218000 |
| Practice Fax Number | 6175312081 |
| Mailing Telephone | 6172218000 |
| Mailing Fax Number | 6175312081 |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2019-01-09 |
| Authorized Official Name | THIAGO SOARES (ADMINISTRATOR) |
| Authorized Official Telephone | 5082506936 |
| Is Organization Subpart | Y |
| Parent Organization Name | RELIANT DENTAL GROUP LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
1996 CENTRE ST STE 201 |
| City | WEST ROXBURY |
| State | MA |
| Zip Code | 02132-3330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578042669 | Gustavo Perdomo Dmd PC | Dentist | 1996 Centre St Ste 201, West Roxbury, MA 02132-3330 | 2018-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992299663 | Ashley Monteiro | Counselor | 15 Elgin St, West Roxbury, MA 02132 | 2018-06-18 |
| 1033639943 | Nahed Lakkis | Dentist | 80 New Haven St, West Roxbury, MA 02132 | 2017-06-21 |
| 1053780692 | Yanpeng Ding | Optometrist | 2034a Centre St, West Roxbury, MA 02132 | 2015-09-24 |
| 1013303437 | Alaa Alrababa I | Dentist | 125 Edgemere Road, 202, West Roxbury, MA 02132 | 2015-04-13 |
| 1023426483 | Kearstin F. Thomas D.m.d.,pc | Dentist | 2075 Centre Street, West Roxbury, MA 02132 | 2014-07-30 |
| 1003226630 | Beyond Independent Living LLC | Case Management | 1208b Vfw Parkway, Suite 301, Boston, MA 02132 | 2014-05-05 |
| 1780920223 | Kysa Christie | Psychologist | 1400 Vfw Parkway (sci 128), West Roxbury, MA 02132 | 2013-01-02 |
| 1629324652 | Mohamed Al-janabi | Dentist | 250 Spring St, Apt 18, West Roxbury, MA 02132 | 2012-07-27 |
| 1265704787 | Ronda Denise Jones | Case Manager/Care Coordinator | 2077 Centre Street, West Roxbury, MA 02132 | 2012-01-30 |
| 1306123419 | Hung Doan | Pharmacist | 1065 Truman Highway, Hyde Park, MA 02132 | 2011-11-03 |
| Find all providers in zip 02132 | ||||
| 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 |
|---|---|---|---|---|
| 1013303437 | Alaa Alrababa I | Dentist | 125 Edgemere Road, 202, West Roxbury, MA 02132 | 2015-04-13 |
| 1528206521 | Dental Health Works PC | Dentist | 1864 Centre Str, Ste 1, West Roxbury, MA 02132 | 2009-01-29 |
| 1285857813 | Brian Mark Shea | Dentist | 335 Corey Street, West Roxbury, MA 02132-1614 | 2007-04-11 |
| 1912021528 | Allan C Levy | Dentist | 1208b Vfw Pkwy Ste 307, West Roxbury, MA 02132-4350 | 2007-03-19 |
| 1194895185 | Neela Gandhi | Dentist | 1852 Centre Street, Gentle Dental Center, West Roxbury, MA 02132 | 2006-11-08 |
| 1417043308 | Harpal Kaur Bhan | Dentist | 540 Vfw Pkwy Ste 5, West Roxbury, MA 02132-1332 | 2006-10-05 |
| 1366536591 | Stanley J Rozanski | Dentist | 1852 Centre St, West Roxbury, MA 02132-1901 | 2006-10-03 |
| 1275631392 | Eugene Petti | Dentist | 5230 Washington St, West Roxbury, MA 02132 | 2006-09-20 |
| 1689681371 | Kearstin Frances Thomas | Dentist | 1864 Centre St, Suite 1, West Roxbury, MA 02132 | 2006-08-02 |
| 1528074838 | Richard W Shea | Dentist | 335 Corey St, West Roxbury, MA 02132 | 2006-07-31 |
| Find all providers in WEST ROXBURY | ||||
| City | WEST ROXBURY |
| Zip Code | 02132 |
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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.