AQUA DENTAL LLC (NPI# 1336392505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336392505 |
| Entity Type | Organization |
| Organization Name | AQUA DENTAL LLC |
| Practice Address |
1395 N Main St Randolph MA 02368-1768 |
| Practice Telephone | 7819636077 |
| Mailing Telephone | 7819636077 |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2008-10-31 |
| Authorized Official Name | JEFFREY FAYERMAN (OWNER) |
| Authorized Official Telephone | 7819636077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
18450 | MA | Ambulatory Health Care Facilities |
| Street Address |
1395 N MAIN ST |
| City | RANDOLPH |
| State | MA |
| Zip Code | 02368-1768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356405435 | Rosemary Doherty Byrne | Nurse Practitioner | 1395 N Main St, Randolph, MA 02368-1768 | 2006-12-21 |
| 1366898413 | Matthew Devine | Dentist | 1395 N Main St, Randolph, MA 02368-1768 | 2016-05-09 |
| 1528428976 | Michael Wayne Brown | Dentist | 1395 N Main St, Randolph, MA 02368-1768 | 2016-02-27 |
| 1699197913 | Regional Home Care Inc | Durable Medical Equipment & Medical Supplies | 1395 N Main St, Suite F, Randolph, MA 02368-1768 | 2014-01-07 |
| 1972812469 | New Hyperbaric Oxygen Treatment | Clinic/Center | 1395 N Main St, Suite G, Randolph, MA 02368 | 2010-09-30 |
| 1487860102 | Annmarie Hayes | Nurse Practitioner | 1395 N Main St, Randolph, MA 02368-1768 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016444 | Kadiatou Djindji Bah | Behavior Technician | 75 N Main St Suite 628, Randolph, MA 02368 | 2020-09-02 |
| 1194334490 | Madison Murphy | Behavior Technician | 75 North Main Street, Ma, Suite #628, Randolph, MA 02368 | 2020-07-23 |
| 1255995049 | Daniel Joseph Bellistri | Social Worker | Daniel Bellistri, 70 Memorial Pkwy., Randolph, MA 02368 | 2019-04-26 |
| 1992291124 | Ashley Lauren Davis | Licensed Practical Nurse | 11 Mcdonnell Drive, Randolph, MA 02368 | 2018-07-11 |
| 1023503943 | Jean Rony Mesalon | Licensed Practical Nurse | 8 Reynolds Ave, Randolph, MA 02368 | 2018-06-22 |
| 1154829208 | Tatianna Lovette Hendren | Behavioral Analyst | 28 Liberty Place, Apartment C, Randolph, MA 02368 | 2018-01-24 |
| 1841709698 | Gerica Barbosa | Counselor | 37 Sarah St, Randolph, MA 02368 | 2017-09-25 |
| 1437508629 | Julie A Panchamsingh-barakat | Social Worker | 400-, 402 N Main St, Randolph, MA 02368 | 2016-06-08 |
| 1497109789 | Grace Dorcas Pokuah | Counselor | 24 Nelson Dr, #1a, Randolph, MA 02368 | 2016-04-22 |
| 1194185868 | Heavenly Home Care | Home Health | 9 William Morrison Drive, Randolph, MA 02368 | 2016-02-24 |
| Find all providers in zip 02368 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578922951 | Rossy Pediatric Dentistry, LLC | Clinic/Center | 11 Heather Ln, Randolph, NJ 07869-3332 | 2016-02-15 |
| 1376897108 | Jimmy Lai Dmd PC | Clinic/Center | 10 Mazzeo Dr Ste 209, Randolph, MA 02368-3433 | 2012-10-31 |
| 1700232212 | Gifford Health Care, Inc | Clinic/Center | 44 S Main St, Randolph, VT 05060-1381 | 2016-05-13 |
| 1972831428 | Comfort Dental Care | Clinic/Center | 15 Warren St, Randolph, MA 02368-4015 | 2009-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265771 | Sidhu Family Dental LLC | Clinic/Center | 15 West St Ste 101, Douglas, MA 01516-2160 | 2020-11-04 |
| 1205436276 | The Nurture Frenectomy Center | Clinic/Center | 200 Elm St Ste 1, Pittsfield, MA 01201-6551 | 2020-10-29 |
| 1417557463 | Marva Khalid Dentistry PC | Clinic/Center | 105 Chestnut St Ste 25, Needham, MA 02492-2520 | 2020-10-29 |
| 1417555855 | Gardner Smiles Pllc | Clinic/Center | 356 Timpany Blvd, Gardner, MA 01440-5200 | 2020-10-16 |
| 1326646399 | Restoration Smiles, P.C. | Clinic/Center | 2 Coolidge St Ste 202, Hudson, MA 01749-1459 | 2020-10-13 |
| 1295333573 | Brian P. Ganley, Dmd, PC | Clinic/Center | 134 Main St Unit 1c, Groton, MA 01450-1375 | 2020-10-09 |
| 1619583168 | Newton Wellesley Dental Group LLC | Clinic/Center | 447 Centre Street, Same, Newton, MA 02458 | 2020-09-21 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1831703099 | Beacon Dental Health PC | Clinic/Center | 80 Washington St Bldg B, Norwell, MA 02061-1740 | 2020-09-04 |
| 1487267282 | Shoe City Family Dental PC | Clinic/Center | 103 Merrimack St, Haverhill, MA 01830-6208 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
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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.