42 NORTH DENTAL CARE, LLC (NPI# 1689229171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689229171 |
| Entity Type | Organization |
| Organization Name | 42 NORTH DENTAL CARE, LLC |
| Practice Address |
23 Riverside Ave Medford MA 02155-4605 |
| Practice Telephone | 7816470772 |
| Mailing Telephone | 7816470772 |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |
| Authorized Official Name | TAFPHANE LEGRANDE (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Telephone | 7816470772 |
| Is Organization Subpart | Y |
| Parent Organization Name | 42 NORTH DENTAL CARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Gentle Dental - Medford | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649730334 | 42 North Dental Care, LLC | Clinic/Center | 41 Park Ave Ste 3-4, Worcester, MA 01605-3947 | 2019-03-20 |
| 1205868098 | 42 North Dental Care, LLC | Dentist | 200 5th Ave, Waltham, MA 02451-8779 | 2006-07-06 |
| 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 |
23 RIVERSIDE AVE |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-4605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609400035 | Medford Family Dental Care | Clinic/Center | 101 Main St Ste 220, Medford, MA 02155-4530 | 2020-02-25 |
| 1104478619 | David A Allen Dds | Clinic/Center | 1059 Royal Ave, Medford, OR 97504-6127 | 2019-07-15 |
| 1174073043 | Creekside Family Dental | Clinic/Center | 1234 N Riverside Ave, Medford, OR 97501-4619 | 2016-10-04 |
| 1487005914 | Gio Dental At Station Landing | Clinic/Center | 8 Earhart Lndg, Medford, MA 02155-4964 | 2016-06-27 |
| 1962640771 | Jacob O. Layer, Dmd, PC | Clinic/Center | 1485 E Mcandrews Rd, Medford, OR 97504-6107 | 2009-02-02 |
| 1801074000 | First Dental, PC | Clinic/Center | 366 Salem St, Medford, MA 02155-3307 | 2008-02-11 |
| 1588848055 | Southern Oregon Periodontics, PC | Clinic/Center | 1762 E Mcandrews Rd Ste B, Medford, OR 97504-5577 | 2007-12-20 |
| 1326537143 | Jacob J Foutz Dmd, LLC | Clinic/Center | 806 E Jackson St, Medford, OR 97504-6773 | 2018-05-07 |
| 1578003901 | A Elite Dental, Inc | Clinic/Center | 3502 Excel Dr, #101, Medford, OR 97504-9136 | 2017-03-04 |
| 1497101430 | South Jersey Dental Sleep Center LLC | Clinic/Center | 76 N Main St, Medford, NJ 08055-2720 | 2016-05-09 |
| Find all providers in MEDFORD | ||||
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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.