CENTER FOR DENTAL MEDICINE & RECONSTRUCTION (NPI# 1083278378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083278378 |
| Entity Type | Organization |
| Organization Name | CENTER FOR DENTAL MEDICINE & RECONSTRUCTION |
| Practice Address |
152 Lincoln Rd Ste 1 Lincoln MA 01773-3832 |
| Mailing Address |
32 Traveler St Unit 510 Boston MA 02118-2840 |
| Practice Telephone | 7817285455 |
| Mailing Telephone | 6178515463 |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |
| Authorized Official Name | DR. QUINN CHAN (OWNER/MANAGER) |
| Authorized Official Telephone | 7817285455 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1821365479 | 05 | |
| MA | 1669663886 | 05 |
| Street Address |
152 LINCOLN RD STE 1 |
| City | LINCOLN |
| State | MA |
| Zip Code | 01773-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669663886 | Quinn Kin-wung Chan | Dentist | 152 Lincoln Rd Ste 1, Lincoln, MA 01773 | 2007-08-05 |
| 1821365479 | Bina Oh | Dentist | 152 Lincoln Rd Ste 1, Lincoln, MA 01773-3832 | 2011-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205330230 | Jacqueline Butler | Social Worker | Care Dimensions, 125 Winter Street, Lincoln, MA 01773 | 2018-03-23 |
| 1477988392 | Carlin Maiorana | Social Worker | 11 Old County Rd, Lincoln, MA 01773 | 2013-09-10 |
| 1326068396 | Paula F. Angelini | Podiatrist | 14 Old Winter St, Lincoln, MA 01773 | 2006-07-20 |
| 1184756934 | Youjin Natalie Jeong | Dentist | 160 Lincoln Rd, Lincoln, MA 01773 | 2007-03-09 |
| 1407015258 | Annamaria Sanantonio | Massage Therapist | 62a Conant Rd, Lincoln, MA 01773-0563 | 2008-06-06 |
| 1306174990 | Autumn Research | Skilled Nursing Facility | 5b S Commons, Lincoln, MA 01773-1114 | 2009-11-19 |
| 1316912264 | Suzanne Stoterau | Psychiatry & Neurology | 6 Brooks Rd, Lincoln, MA 01773-1312 | 2006-02-22 |
| 1174647127 | Julia Anne Tryder | Student in an Organized Health Care Education/Training Program | 7 Juniper Ridge Rd, Lincoln, MA 01773-1502 | 2007-03-16 |
| 1790809754 | Alanna Claire Tryder | Student in an Organized Health Care Education/Training Program | 7 Juniper Ridge Rd, Lincoln, MA 01773-1502 | 2007-03-16 |
| 1083960389 | Taline Tokatlian | Pharmacist | 3 Acorn Ln, Lincoln, MA 01773-1505 | 2012-07-24 |
| Find all providers in zip 01773 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003193152 | Bongok Kim | Dentist | 3885 Holdrege St., Lincoln, NE 68583-0740 | 2011-11-03 |
| 1669663886 | Quinn Kin-wung Chan | Dentist | 152 Lincoln Rd Ste 1, Lincoln, MA 01773 | 2007-08-05 |
| 1821132960 | Joan E. Sivers | Dentist | 3885 Holdrege, 137, Lincoln, NE 68583-0740 | 2007-02-19 |
| 1578892998 | Steven Eric Haas | Dentist | 4000 East Campus Loop South, Lincoln, NE 68583-0740 | 2009-12-14 |
| 1366604761 | Omaid K Ahmad | Dentist | 40th and Holdrege Street, Lincoln, NE 68583-0740 | 2008-06-26 |
| 1891900502 | Paul A Hansen | Dentist | 1217 N Cotner Blvd, Lincoln, NE 68505-1837 | 2007-05-14 |
| 1366589400 | Julie Ann Marshall | Dentist | 2810 S 48th St, Lincoln, NE 68506-3391 | 2007-01-30 |
| 1851469704 | Eunghwan Kim | Dentist | 40th and Holdrege, Unmc College of Dentistry, Lincoln, NE 68583-0740 | 2006-11-30 |
| 1710081716 | Gerard Byrne | Dentist | 40th and Holdrege Streets, University of Nebraska Medical Center, College of Denti, Lincoln, NE 68583-0740 | 2006-09-11 |
| 1609865518 | Jennifer Ann Reed | Dentist | 2900 S 70th St, Suite 230, Lincoln, NE 68506-3688 | 2005-10-14 |
| Find all providers in LINCOLN | ||||
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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.