EVERGREEN DENTAL LLC (NPI# 1831513126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831513126 |
| Entity Type | Organization |
| Organization Name | EVERGREEN DENTAL LLC |
| Practice Address |
790 Boston Rd Unit 205 Billerica MA 01821-5938 |
| Practice Telephone | 4049328875 |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-07 |
| Authorized Official Name | JANGWON HUH (PRESIDENT) |
| Authorized Official Telephone | 4049328875 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN1855668 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730464470 | Evergreen Dental LLC | Dentist | 109 Boston Post Rd, Orange, CT 06477-3235 | 2011-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | EVERGREEN DENTAL LLC | 6333 Avalon Drive West, Orange, CT 06477 |
| Street Address |
790 BOSTON RD UNIT 205 |
| City | BILLERICA |
| State | MA |
| Zip Code | 01821-5938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828490 | Bh Brightview Concord River Opco, LLC | Alzheimer Center (Dementia Center) | 199 Concord River, Billerica, MA 01821 | 2019-12-12 |
| 1225503857 | Lori Ann Silva | Nurse Practitioner | 5 River Street, Billerica, MA 01821 | 2018-10-10 |
| 1255819090 | Kacie Dawn Melo | Counselor | Billerica Memorial High School 35 River St, Billerica, MA 01821 | 2018-08-03 |
| 1750889937 | Cassidy Erin Lapointe | Behavior Technician | 120 Pollard St, Billerica, MA 01821 | 2018-01-23 |
| 1679025993 | Shp Iv Concord River LLC | Alzheimer Center (Dementia Center) | 199 Concord Road, Billerica, MA 01821 | 2016-11-03 |
| 1790110393 | Michele Lee Krasinski | Registered Nurse | 100 Partridge Road, Billerica, MA 01821 | 2013-09-13 |
| 1538591573 | Riverside Community Care | Community/Behavioral Health | 5 Riverhurst Road Apartment 516, Billerica, MA 01821 | 2013-08-01 |
| 1780029900 | Stephen D Fell | Hearing Instrument Specialist | 26 Mount Vernon Avenue, Billerica, MA 01821 | 2013-05-01 |
| 1578822268 | Akhtar Khan | Dentist | 8 Tower Farm Rd., Billerica, MA 01821 | 2012-05-15 |
| 1942584578 | Mary Louise Kellerman | Dental Hygienist | 38 Pratt St., Billerica, MA 01821 | 2011-09-30 |
| Find all providers in zip 01821 | ||||
| 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 |
|---|---|---|---|---|
| 1124644844 | Maryam Moghtader | Dentist | 480 Boston Rd Unit 114, Billerica, MA 01821-2707 | 2020-06-18 |
| 1215456512 | Kristen Marie O'brien | Dentist | 348 Boston Rd, Billerica, MA 01821-1812 | 2017-09-18 |
| 1578822268 | Akhtar Khan | Dentist | 8 Tower Farm Rd., Billerica, MA 01821 | 2012-05-15 |
| 1952604431 | Adam Danzig | Dentist | 662 Boston Road, Billerica, MA 01821 | 2010-12-06 |
| 1871650945 | Scott Ira Goldberg | Dentist | 17 Bridge St., Suite 204, Billerica, MA 01821 | 2007-01-01 |
| 1790761815 | Allen L Friedman | Dentist | 337 Boston Rd, Billerica, MA 01821-1819 | 2005-12-20 |
| 1952386609 | Robert Michael Buxbaum | Dentist | 2 Andover Road, Billerica, MA 01821 | 2005-12-14 |
| 1841691946 | Marjan Fakhri | Dentist | 337 Boston Rd, Billerica, MA 01821-1819 | 2014-09-08 |
| 1629253026 | Matthew Healey | Dentist | 446 Boston Rd, Billerica, MA 01821-2714 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861339 | Lexington Dental Group LLC | Dentist | 35 Bedford St Ste 110, Lexington, MA 02420-4320 | 2020-11-06 |
| 1538760947 | Jevon K Rhule | Dentist | 3611 Washington St Unit B523, Jamaica Plain, MA 02130-2960 | 2020-11-03 |
| 1992304612 | Milton Hill Dental Pllc | Dentist | 99 Adams St, Milton, MA 02186-3413 | 2020-10-23 |
| 1043818404 | Daniela Toli Shkurti | Dentist | 28 Lorette St, West Roxbury, MA 02132-3308 | 2020-10-16 |
| 1194323428 | Farnaz Chehrazi | Dentist | 133 Park St Apt 603, Brookline, MA 02446-4984 | 2020-10-09 |
| 1497353619 | Shikha Nanda | Dentist | 45 E Newton St Apt 107, Boston, MA 02118-4803 | 2020-10-09 |
| 1497352744 | Shahad Hadadi | Dentist | 2 Hancock St Apt 504, Quincy, MA 02171-1769 | 2020-10-08 |
| 1063019677 | Gauri Patil | Dentist | 22 Deborah Dr, Walpole, MA 02081-2317 | 2020-10-06 |
| 1245837152 | Marwan S Al-daggistany | Dentist | 1 Crown Dr Unit 101, Quincy, MA 02169-5474 | 2020-10-04 |
| 1548867443 | Bahareh Kiabi | Dentist | 66 Devir St Apt 201, Malden, MA 02148-7235 | 2020-10-04 |
| 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.