JACK AND JILL PEDIATRIC DENTISTRY, LLC (NPI# 1184002180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184002180 |
Entity Type | Organization |
Organization Name | JACK AND JILL PEDIATRIC DENTISTRY, LLC |
Practice Address |
340 Wood Rd Suite 288 Braintree MA 02184-2401 |
Mailing Address |
340 Wood Road Suite 288 Braintree MA 02184 |
Practice Telephone | 6179138307 |
Enumeration Date | 2015-05-11 |
Last Update Date | 2015-05-11 |
Authorized Official Name | DR. NGUYET MINH TAU (DENTIST/OWNER) |
Authorized Official Telephone | 5088648997 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
21959 | MA | Dental Providers |
Street Address |
340 WOOD RD SUITE 288 |
City | BRAINTREE |
State | MA |
Zip Code | 02184-2401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538140868 | Kathryn Anne Foley Ferrari | Physical Therapist | 340 Wood Rd, Suite 303, Braintree, MA 02184-2401 | 2005-11-14 |
1578054730 | Angela Tchao | Optometrist | 340 Wood Rd, Braintree, MA 02184 | 2018-05-23 |
1598219313 | Sydney Galvin | Physical Therapist | 340 Wood Rd, Ste 303, Braintree, MA 02184-2401 | 2016-08-10 |
1396150629 | Blue Hills Sport & Spine Rehabilitation, LLC | Physical Therapist | 340 Wood Rd, Ste 303, Braintree, MA 02184-2401 | 2014-06-25 |
1881024545 | Crowning Moment LLC | Preferred Provider Organization | 340 Wood Rd, Suite 288, Braintree, MA 02184-2401 | 2013-11-16 |
1750654018 | Brad Thorne | Counselor | 340 Wood Rd, Braintree, MA 02184-2401 | 2012-02-17 |
1992935381 | Allison P Daly | Nurse Practitioner | 340 Wood Rd, 305, Braintree, MA 02184-2401 | 2009-07-20 |
1780819300 | New England Pain Associates, PC | Anesthesiology | 340 Wood Rd, Ste. 204, Braintree, MA 02184-2401 | 2009-05-27 |
1710145867 | Deborah Levenson | Physical Therapist | 340 Wood Rd, Suite 102, Braintree, MA 02184-2401 | 2008-05-27 |
1417114695 | Laura Cecchi Mccullough | Pediatrics | 340 Wood Rd, Suite 301, Braintree, MA 02184-2401 | 2008-05-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396342234 | Albert Jusu | Counselor | Arbour Counseling Services, 400 Washington Street, Braintree, MA 02184 | 2020-10-05 |
1356952378 | Samantha Taylor O'malley | Student in an Organized Health Care Education/Training Program | 639 Granite Street, N/a, Brainetree, MA 02184 | 2020-08-13 |
1184104499 | Andrea Boudreau | Social Worker | Coastal Dcf, 220 R Forbes Road, Braintree, MA 02184 | 2018-08-16 |
1144747221 | Mina Schafft Dmd Pllc | Dentist | 321 Washington Street, Unit 101, Westwood, MA 02184 | 2017-08-29 |
1922520592 | Samson Michel | Counselor | 400 Washington St. Suite 106, Braintree, MA 02184 | 2017-07-14 |
1760912653 | Shannon R Harvey | Behavioral Analyst | 501 Commerce Dr 4207, Braintree, MA 02184 | 2017-06-14 |
1275074429 | Colleen Dalton | Behavioral Analyst | 32 Powder Hill Dr, Braintree, MA 02184 | 2017-03-20 |
1295273266 | Jessica Morris | Occupational Therapist | 16 Kensington Street, Braintree, MA 02184 | 2017-02-09 |
1568834562 | Lisa Morrill | Counselor | 400 Washington St Ste 106, Braintree, MA 02184 | 2015-10-29 |
1831560382 | Dr Dental of Braintree PC | Dentist | 284 Grove St, Braintree, MA 02184 | 2015-10-09 |
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Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | 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. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437784378 | Braintree Dentistry and Braces PC | Dentist | 292 Grove St, Braintree, MA 02184-7209 | 2020-03-11 |
1801943394 | Braintree Pediatric Dental Associates, LLC | Dentist | 400 Washington St, #301, Braintree, MA 02184-4729 | 2007-01-05 |
1629047139 | Raymond Widican | Dentist | 111 Grossman Dr, Braintree, MA 02184-4997 | 2006-03-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
1215575311 | Martha Forero | Dentist | 1 Kneeland St Fl 15, Boston, MA 02111-1527 | 2019-12-19 |
1215574694 | Nistar Pediatric Dentistry Pllc | Dentist | 76 Merrimack St Ste 8a, Haverhill, MA 01830-6246 | 2019-12-05 |
1952968729 | Hampshire Meadow Family & Pediatric Dentistry | Dentist | 207 Russell St Apt 18, Hadley, MA 01035-5907 | 2019-05-28 |
1801352661 | Lavoie Pediatric Dentistry | Dentist | 2200 Gar Hwy Ste 2, Swansea, MA 02777-3935 | 2019-02-18 |
1790254845 | Somerville Pediatric Dentistry and Orthodontics | Dentist | 51 Cross St, Somerville, MA 02145-3244 | 2018-11-19 |
1730660903 | Matthew Brian Harper | Dentist | 300 Longwood Ave Fl 4, Boston, MA 02115-5724 | 2018-08-27 |
1891286316 | Azadeh Sajjadi | Dentist | 29 Angela Ln, Watertown, MA 02472-1734 | 2018-05-21 |
1841789468 | Tiffany Juliana Lewis | Dentist | 413 Broadway Ste B, Methuen, MA 01844-2062 | 2018-05-09 |
1700387453 | Dorchester Pediatric Dentistry and Orthodontics, PC | Dentist | 1192 Blue Hill Ave Unit 1192, Boston, MA 02126-1819 | 2018-02-27 |
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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.