PARK PROSTHODONTICS, PLLC (NPI# 1164078655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164078655 |
| Entity Type | Organization |
| Organization Name | PARK PROSTHODONTICS, PLLC |
| Practice Address |
800 Boylston St Fl 2 Boston MA 02199-8081 |
| Mailing Address |
776 Main St Unit 540085 Waltham MA 02454-5405 |
| Practice Telephone | 6178299744 |
| Mailing Telephone | 2039215437 |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |
| Authorized Official Name | DR. CARLY PARK (OWNER) |
| Authorized Official Telephone | 2039215437 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers |
| Street Address |
800 BOYLSTON ST FL 2 |
| City | BOSTON |
| State | MA |
| Zip Code | 02199-8081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942866900 | Carly F Park | Dentist | 800 Boylston St Fl 2, Boston, MA 02199-1900 | 2019-05-15 |
| 1043818610 | Jessica Lau Dmd Pllc | Dentist | 800 Boylston St Fl 2, Boston, MA 02199-8081 | 2020-10-15 |
| 1053932574 | Boston Dental Esthetics LLC | Dentist | 800 Boylston St Fl 2, Boston, MA 02199-1900 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568856953 | Dental Delights PC | Dentist | 770 Boylston Street, Apt#4d, Boston, MA 02199 | 2015-03-24 |
| 1811206444 | Amy Boyce | Dietitian, Registered | 800 Boylston St., Fitcorp, Prudential Center, Boston, MA 02199 | 2010-09-30 |
| 1629217807 | Enrico Petrillo | Internal Medicine | Cb Health Ventures, L.L.C., 800 Boylston St . Suite 1585, Boston, MA 02199 | 2009-02-12 |
| 1053465542 | Minaj Naimi | Dentist | 800 Boyston Street, Suite 200, Boston, MA 02199 | 2007-01-22 |
| 1578617163 | Michael O Toole | Dentist | 800 Boylston Street, Suite 200, Boston, MA 02199 | 2007-01-22 |
| 1609952555 | Laurie Kaslow | Social Worker | 56 Dimock Street, Roxbury, MA 02199 | 2006-10-31 |
| 1073088241 | And Still We Rise, LLC | Community/Behavioral Health | 800 Boylston St, Floor 16, Boston, MA 02199 | 2018-10-03 |
| 1598029084 | Brad Shattuck | Psychiatry & Neurology | 800 Boylston St., 16th Floor, Boston, MA 02199 | 2012-06-28 |
| 1518007392 | Charles M Travring | Dentist | 800 Boylston Street, Suite 200, Boston, MA 02199 | 2007-02-08 |
| 1790824985 | Maria E Cardenas | Dentist | 800 Boylston Street, Suite 200, Boston, MA 02199 | 2007-02-05 |
| Find all providers in zip 02199 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952852063 | Thaisa Barizan Bordin | Dentist | 100 Morton St Apt 50, Boston, MA 02130-3754 | 2016-10-24 |
| 1295113355 | Mission Hill Dental Services | Dentist | 780 Boylston St Apt 3c, Boston, MA 02199-7802 | 2015-05-09 |
| 1528475613 | Smile Design Innovations | Dentist | Oral Design 11 Newbury Street, Smile Design Innovations, Boston, MA 02116 | 2014-07-21 |
| 1457762569 | Julie Ann Mitchell | Dentist | 175 Cambridge St Ste 310, Boston, MA 02114 | 2014-05-12 |
| 1629354964 | Irays Santamaria | Dentist | 396 Commonwealth Ave Ste 103a, Boston, MA 02215-2823 | 2011-11-01 |
| 1952695892 | Chaimongkon Peampring | Dentist | 315 Huntington Ave, #2b, Boston, MA 02115-4444 | 2011-06-08 |
| 1447494521 | Dong-soo Hong | Dentist | 9 Knapp St. #401, Boston, MA 02111 | 2009-04-21 |
| 1831340991 | Waleerat Kaweevisaltrakul | Dentist | 100 E Newton St # G219, Boston, MA 02118-2308 | 2008-10-08 |
| 1639329121 | Bader A Al-awadhi | Dentist | 130 Dartmouth Street #315, Boston, MA 02116 | 2008-09-22 |
| 1710133582 | Pamela Marie Maragliano | Dentist | Lewis Wharf Bay 237, Boston, MA 02110 | 2008-08-13 |
| Find all providers in BOSTON | ||||
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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.