SOMERVILLE PEDIATRIC DENTISTRY AND ORTHODONTICS (NPI# 1790254845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790254845 |
| Entity Type | Organization |
| Organization Name | SOMERVILLE PEDIATRIC DENTISTRY AND ORTHODONTICS |
| Practice Address |
51 Cross St Somerville MA 02145-3244 |
| Practice Telephone | 6176423139 |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |
| Authorized Official Name | DR. MOONYOUNG LEE (PRESIDENT) |
| Authorized Official Telephone | 6176423139 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
51 CROSS ST |
| City | SOMERVILLE |
| State | MA |
| Zip Code | 02145-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1811478274 | Rolanda Santos Prophete | Counselor | 18 Sargent Ave, Somerville, MA 02145 | 2018-08-23 |
| 1619465101 | Shannon Comer | Registered Nurse | 64 Sycamore St Apartment 1, Somerville, MA 02145 | 2018-04-30 |
| 1184121261 | Deborah Camara | Social Worker | 89 Cross Street, Apt 1, Somerville, MA 02145 | 2018-04-06 |
| 1073047569 | Nicole Patzelt | Dermatology | 192a School St Apt 2, Somerville, MA 02145 | 2017-04-12 |
| 1316327018 | Christina Gasbarro | Family Medicine | Cha Assembly Square Care Center, 5 Middlesex Avenue, Somerville, MA 02145 | 2015-06-08 |
| 1902236359 | Prativa Bhatta | Counselor | 76 Cross St, Somerville, MA 02145 | 2013-11-21 |
| 1427497015 | Veronica Wu | Physician Assistant | 60 Clyde Street, #5, Somerville, MA 02145 | 2013-06-18 |
| 1790045797 | Cambridge Health Alliance | Rehabilitation Unit | 2 Middlesex Avenue, Somerville, MA 02145 | 2012-05-23 |
| 1871809665 | Lauren Holland | Occupational Therapist | 5 Middlesex Avenue, Somerville, MA 02145 | 2010-08-31 |
| Find all providers in zip 02145 | ||||
| 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 |
|---|---|---|---|---|
| 1952838641 | Helen Stamatouras | Dentist | 133 Heath St, Somerville, MA 02145-1400 | 2017-05-12 |
| 1265684294 | Julianne M Kane | Dentist | 148 West End Ave, Somerville, NJ 08876 | 2008-10-22 |
| 1952696445 | Yang Han Kao | Dentist | 396 Highland Ave, Somerville, MA 02144-2512 | 2011-06-13 |
| 1568587269 | Patricia Castillo | Dentist | 341 Summer St, Somerville, MA 02144 | 2007-03-20 |
| 1457454035 | Lina A Al-aswad | Dentist | 1133 Broadway, Somerville, MA 02144 | 2006-09-07 |
| 1699796193 | Robert B Martin, Dmd, Msd, Pa | Dentist | 2 Park Ave, Somerville, NJ 08876-2318 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437784378 | Braintree Dentistry and Braces PC | Dentist | 292 Grove St, Braintree, MA 02184-7209 | 2020-03-11 |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | SOMERVILLE |
| Zip Code | 02145 |
Please comment or provide details below to improve the information on SOMERVILLE PEDIATRIC DENTISTRY AND ORTHODONTICS.
| 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.