CONCORDDENTAL IMPLANTS &PERIODONTICS (NPI# 1063732477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063732477 |
| Entity Type | Organization |
| Organization Name | CONCORDDENTAL IMPLANTS &PERIODONTICS |
| Practice Address |
290 Baker Ave S205 Concord MA 01742-2189 |
| Mailing Address |
290 Baker Ave Suite205 Concord MA 01742-2189 |
| Practice Telephone | 9783694611 |
| Practice Fax Number | 9783694622 |
| Mailing Telephone | 9783694611 |
| Mailing Fax Number | 9783694622 |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |
| Authorized Official Name | DR. MARK Y. WANG (PRESIDENT) |
| Authorized Official Telephone | 9783694611 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
18710 | MA | Dental Providers |
| Street Address |
290 BAKER AVE S205 |
| City | CONCORD |
| State | MA |
| Zip Code | 01742-2189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184619223 | Michael M Pugliese | Dermatology | 290 Baker Ave, Suite 220n, Concord, MA 01742-2189 | 2005-09-14 |
| 1407356769 | Vivien M Fiset | Physical Therapist | 290 Baker Ave, Concord, MA 01742-2189 | 2018-02-13 |
| 1497201354 | Charming Smile Orthodontics, LLC | Dentist | 290 Baker Ave, Suite S-200, Concord, MA 01742-2189 | 2016-08-31 |
| 1154875102 | Melissa Bloch | Physical Therapist | 290 Baker Ave, Concord, MA 01742-2189 | 2016-08-08 |
| 1952700825 | Sara Elizabeth Heldman | Physical Therapist | 290 Baker Ave, Suite N111, Concord, MA 01742-2189 | 2014-08-17 |
| 1447680657 | Melissa Delrossi | Physical Therapist | 290 Baker Ave, Suite N111, Concord, MA 01742-2189 | 2013-11-25 |
| 1669729299 | Michelle Yuching Chou | Dentist | 290 Baker Ave, Suite S-200, Concord, MA 01742 | 2012-08-14 |
| 1265706071 | Jason Pemberton | Physical Therapist | 290 Baker Ave, Suite N 111, Concord, MA 01742-2189 | 2012-02-27 |
| 1205165586 | Inna Amirian | Dentist | 290 Baker Ave, Concord, MA 01742-2189 | 2009-12-15 |
| 1255581187 | Mass Assoc In Podiatry | Podiatrist | 290 Baker Ave, Ste. N104, Concord, MA 01742-2190 | 2008-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674348 | Camille Arcidi | Dentist | 747 Main Street, Suite 221, Concord, MA 01742 | 2020-09-17 |
| 1851916936 | Paige Hamilton-read | Psychologist | 333 Thoreau Street, Concord, MA 01742 | 2020-06-14 |
| 1467926113 | Judith Segal | Psychologist | 844 Sudbury Road, Concord, MA 01742 | 2019-01-16 |
| 1316422983 | Lisa Colagiovanni | Social Worker | 54 Hillside Ave., Concord, MA 01742 | 2018-09-30 |
| 1932699907 | Margaret C O'hearn-curran | Psychologist | 178 Silver Hill Rd, Concord, MA 01742 | 2018-05-15 |
| 1205358678 | Eva Moen | Pharmacist | 19 Nathan Pratt Drive, Unit 308, Concord, MA 01742 | 2017-07-07 |
| 1215475421 | Hengameh Lavasanifar | Pharmacist | Jcb;131 Ornac Suite 200;, Mgh Cancer Center At Emerson Hospital, Concord, MA 01742 | 2017-02-08 |
| 1255882684 | Stephanie Randazzo | Counselor | 20 Nathan Pratt Drive Unit 209, Concord, MA 01742 | 2016-10-20 |
| 1871943704 | Marjorie E. Cahn | Social Worker | 634 Walden Street, Concord, MA 01742 | 2016-06-22 |
| 1063873842 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | 2284 Main Street, Lahey Health Primary Care, Concord, Concord, MA 01742 | 2016-03-08 |
| Find all providers in zip 01742 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568935153 | Periodontology Associates of Concord, Pllc | Dentist | 290 Baker Ave Ste 3, Concord, MA 01742-2189 | 2019-01-07 |
| 1992037642 | R. Bailey, Jr, Dmd, Pa | Dentist | 6044 Bayfield Parkway, Concord, NC 28027 | 2010-02-05 |
| 1881846236 | Robee Bailey Jr. | Dentist | 6044 Bayfield Pkwy, Concord, NC 28027-7597 | 2008-10-16 |
| 1992990832 | Lisa T Grosso | Dentist | 2425 East St Ste 16, Concord, CA 94520 | 2007-09-13 |
| 1740339605 | Austin H Wang | Dentist | 153 Manchester St Suite 5, Concord, NH 03301 | 2007-01-09 |
| 1164596334 | Farrokh Bashiri | Dentist | 2991 Treat Blvd Ste J, Concord, CA 94518-3604 | 2006-11-20 |
| 1588751564 | Ronald C Haraguchi | Dentist | 2933 Salvio St, Concord, CA 94519-2534 | 2006-10-09 |
| 1942460100 | Jeffrey Stephen Forgosh | Dentist | 280 Pleasant Street, Concord, NH 03301 | 2008-06-11 |
| 1952594053 | Nkemjika Susan Obiechina | Dentist | 1851 Sutter St, Concord, CA 94520-2559 | 2007-08-22 |
| 1942416276 | Jeffrey B Freedman | Dentist | 290 Baker Ave, S103, Concord, MA 01742 | 2007-05-15 |
| Find all providers in CONCORD | ||||
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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.