42 NORTH DENTAL CARE, LLC (NPI# 1205868098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205868098 |
| Entity Type | Organization |
| Organization Name | 42 NORTH DENTAL CARE, LLC |
| Practice Address |
200 5th Ave Waltham MA 02451-8779 |
| Practice Telephone | 7816470772 |
| Practice Fax Number | 7816471086 |
| Mailing Telephone | 7816470772 |
| Mailing Fax Number | 7816471086 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-01-18 |
| Authorized Official Name | DR. SAMUEL SHAMES (PRESIDENT) |
| Authorized Official Telephone | 7816470772 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 13328 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689229171 | 42 North Dental Care, LLC | Clinic/Center | 23 Riverside Ave, Medford, MA 02155-4605 | 2019-08-02 |
| 1649730334 | 42 North Dental Care, LLC | Clinic/Center | 41 Park Ave Ste 3-4, Worcester, MA 01605-3947 | 2019-03-20 |
| 1356975874 | 42 North Dental Care, LLC | Clinic/Center | 382 Grove St, Braintree, MA 02184-7324 | 2020-02-24 |
| 1982250726 | 42 North Dental Care, LLC | Clinic/Center | 21 Main St, Watertown, MA 02472-4403 | 2019-08-16 |
| 1134775059 | 42 North Dental Care, LLC | Clinic/Center | 76 Otis St, Westborough, MA 01581-3315 | 2019-08-15 |
| 1033765953 | 42 North Dental Care, LLC | Clinic/Center | 180 Alewife Brook Pkwy, Cambridge, MA 02138-1102 | 2019-08-15 |
| 1245882604 | 42 North Dental Care, LLC | Clinic/Center | 188 Needham St, Newton, MA 02464-1596 | 2019-07-15 |
| 1760048193 | 42 North Dental Care, LLC | Clinic/Center | 1 E Main St, Northborough, MA 01532-1662 | 2019-05-10 |
| 1013572635 | 42 North Dental Care, LLC | Clinic/Center | 10 Lincoln St, Plymouth, MA 02360-3326 | 2019-05-08 |
| 1851851547 | 42 North Dental Care, LLC | Clinic/Center | 471 W Central St, Franklin, MA 02038-2961 | 2019-03-20 |
| Street Address |
200 5TH AVE |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-8779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659701563 | Carolyn Ferrick | Dentist | 200 5th Ave, Waltham, MA 02451-8779 | 2013-11-14 |
| 1871682906 | Jeffrey Damon Reitzel | Dentist | 200 5th Ave, 3rd Floor, Waltham, MA 02451-8779 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043748254 | Shaina Immaculee Henriquez | Dentist | 862 Lexington St, Waltham, MA 02452-4849 | 2017-06-01 |
| 1306390778 | Yasmin Chebbi | Dentist | 32 South St Ste 100, Waltham, MA 02453-3555 | 2016-08-15 |
| 1699054676 | Poonam Soi | Dentist | 376 Moody St, Waltham, MA 02453-5204 | 2011-08-09 |
| 1821388398 | Dentonic | Dentist | 25 Middlesex Rd, #2, Waltham, MA 02452-6170 | 2011-04-18 |
| 1821306499 | Myungeun Kim | Dentist | 85 River St Ste 2, Waltham, MA 02453-8349 | 2010-09-17 |
| 1427369883 | Nidhi Agarwal | Dentist | 105 Black Bear Dr, Apt # 1701, Waltham, MA 02451-0253 | 2010-06-30 |
| 1992975106 | Robert James Lindberg | Dentist | 32 South Street, Suite 202, Waltham, MA 02453 | 2008-03-04 |
| 1487775375 | John D Meola, Jr | Dentist | 40 2nd Ave Ste 500, Waltham, MA 02451-1114 | 2007-04-02 |
| 1104955723 | Cronins Dental PC | Dentist | 225 Moody St, Waltham, MA 02453 | 2007-03-02 |
| 1801804174 | Michael Shulkin | Dentist | 509 Moody St, Waltham, MA 02453 | 2006-08-03 |
| Find all providers in WALTHAM | ||||
Please comment or provide details below to improve the information on 42 NORTH DENTAL CARE, LLC.
| 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.