PEDIATRIC DENTAL GROUP (NPI# 1447700497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447700497 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL GROUP |
| Practice Address |
38 Sw Cutoff Northborough MA 01532-2159 |
| Mailing Address |
5 Mount Royal Ave Suite 300 Marlborough MA 01752-1981 |
| Practice Telephone | 5084735437 |
| Mailing Telephone | 5084600632 |
| Mailing Fax Number | 5088720781 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | JOANNE TAVANO (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9785801524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | MA | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376946244 | Pediatric Dental Group | Dentist | 5518 Lake Howell Rd, Winter Park, FL 32792-1036 | 2014-10-06 |
| 1972770097 | Pediatric Dental Group | Dentist | 5415 Sw Westgate Dr, Suite 207, Portland, OR 97221-2409 | 2008-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pediatric Dental Group at Kids First, PC | 96 Wadsworth Blvd., Suite B, Lakewood, CO 80226 |
| Colorado Business Entities | Pediatric Dental Group of Arvada, PC | 7975 Allison Way, Arvada, CO 80005 |
| Colorado Business Entities | Pediatric Dental Group of Colorado, PLLC | 7975 Allison Way, Arvada, CO 80005 |
| Colorado Business Entities | Pediatric Dental Group of Lakewood, PC | 3333 W. Wadsworth Blvd, #b104, Lakewood, CO 80227 |
| Colorado Business Entities | Pediatric Dental Group of Summit County, PC | 360 Peak One Dr, Frisco, CO 80443 |
| Colorado Business Entities | Pediatric Dental Group of Wheat Ridge, PC | Medical Office Building Iv, 3555 Lutheran Parkway, Suite 310, Wheat Ridge, CO 80033 |
| Oklahoma Business Registrations | PEDIATRIC DENTAL GROUP, LLC | 602 S Utica, Tulsa, OK 74104 |
| Street Address |
38 SW CUTOFF |
| City | NORTHBOROUGH |
| State | MA |
| Zip Code | 01532-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669471918 | Eloise R Colasanto-saia | Nutritionist | 38 Sw Cutoff, Suite B, Northborough, MA 01532-2159 | 2005-07-19 |
| 1073058665 | Oral Surgery Partners PC | Dentist | 38 Sw Cutoff, Northborough, MA 01532-2159 | 2017-01-05 |
| 1407279763 | Life Care Physical Therapy | Clinic/Center | 38 Sw Cutoff, B, Northborough, MA 01532-2159 | 2014-01-22 |
| 1609049832 | Danielle Louise Hanlon | Chiropractor | 38 Sw Cutoff, Northborough, MA 01532-2159 | 2008-04-09 |
| 1396939583 | Children's Dentistry of Northborough | Dentist | 38 Sw Cutoff, Suite D, Northborough, MA 01532-2159 | 2007-08-30 |
| 1396872230 | Mary An Gracie Moyer | Physical Therapist | 38 Sw Cutoff, Northborough, MA 01532-2159 | 2007-02-27 |
| 1891718110 | Jolanta Maria Macdonald | Dentist | 38 Sw Cutoff, Northborough, MA 01532-2159 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073152153 | Authentic Wellness Therapy LLC | Clinic/Center | Authentic Wellness Therapy LLC, 300 West Main Street, Building B, Northborough, MA 01532 | 2020-01-06 |
| 1396225819 | Shannon Furgal | Behavior Technician | 359 Whitney St, Northborough, MA 01532 | 2018-08-14 |
| 1487145926 | Jonathan Ye | Dentist | 448 Howard St, Northborough, MA 01532 | 2018-05-21 |
| 1205219441 | Nuch of Massachusetts, LLC | Clinic/Center | 10002 Shops Way, Suite A, Northborough, MA 01532 | 2015-07-07 |
| 1164775243 | Christine B Chapman | Nurse Practitioner | 10002 Shops Way Ste A, Northborough, MA 01532 | 2012-10-26 |
| 1013269927 | Lindsay Brady | Social Worker | 295 Crawford St., Northborough, MA 01532 | 2012-10-03 |
| 1366763047 | Christine Rodriguez | Counselor | 20 Main Street, Northborough, MA 01532 | 2010-06-17 |
| 1417189432 | Deborah Anne Carter | Social Worker | 130 Main St., Bldg. 2 Suite F, Northborough, MA 01532 | 2009-08-10 |
| 1780802561 | Department of Mental Health | Case Management | 40 Institute Rd, Oaks B Bldg, Southbridge - Milford Cm, No Grafton, MA 01532 | 2007-04-24 |
| 1285787747 | Karen Leigh Lilley | Counselor | 21 Southwest Cutoff, Northborough, MA 01532 | 2007-01-19 |
| Find all providers in zip 01532 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396208690 | Marla P. Meyer, Licsw LLC | Point of Service | 39 Norman St Fl 3, Salem, MA 01970-3380 | 2019-04-12 |
| 1972037562 | Metrowest Dental Center | Point of Service | 433 Center St Ste 7, Ludlow, MA 01056-2857 | 2017-04-20 |
| 1063963353 | Fitchburgh Dentistry and Braces PC | Point of Service | 505 John Fitch Hwy, Fitchburg, MA 01420-8403 | 2016-10-21 |
| 1427506443 | Chrystal Jenkins | Point of Service | 26 Millett St, Unit #1, Gloucester, MA 01930-2846 | 2016-09-19 |
| 1083168132 | Mendon Family Dentistry | Point of Service | 14 Hastings St, Mendon, MA 01756-1079 | 2016-08-06 |
| 1770969024 | Beacon Aba Services | Point of Service | 5111 Avalon Dr, Weymouth, MA 02188-4614 | 2015-08-09 |
| 1679958573 | Any Lab Draw Now LLC | Point of Service | 64 Lambert Ave, Apt 1, Roxbury, MA 02119-1737 | 2015-07-21 |
| 1447637236 | Patrick Assioun Dmd PC | Point of Service | 150 Coolidge Rd, Berlin, MA 01503-1326 | 2015-04-30 |
| 1407257207 | New England Family Dentistry | Point of Service | 70 Westgate Drive, Brockton, MA 02301 | 2014-09-11 |
| 1588075550 | Seaport Chiropractic | Point of Service | 28 Bessom Street, Marblehead, MA 01945 | 2014-05-13 |
| Find all providers with the same taxonomy | ||||
| City | NORTHBOROUGH |
| Zip Code | 01532 |
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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.