DEDHAM MEDICAL ASSOCIATES (NPI# 1407857030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407857030 |
| Entity Type | Organization |
| Organization Name | DEDHAM MEDICAL ASSOCIATES |
| Practice Address |
1 Lyons St Dedham MA 02026-5599 |
| Mailing Address |
Po Box 9120 Dedham MA 02027-9120 |
| Practice Telephone | 7813291400 |
| Practice Fax Number | 7812785667 |
| Mailing Telephone | 7813291400 |
| Mailing Fax Number | 7812785667 |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RICHARD M RUSSO (CFO) |
| Authorized Official Telephone | 7812785540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
========= | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 9766537 | 05 | |
| MA | 9766634 | 05 | |
| MA | 9766596 | 05 | |
| MA | 9766553 | 05 | |
| MA | 9766626 | 05 | |
| MA | 9766529 | 05 | |
| MA | 9766561 | 05 | |
| MA | 9766545 | 05 | |
| MA | 9766588 | 05 | |
| MA | 9766618 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174827745 | Dedham Medical Associates | Clinical Medical Laboratory | 1 Lyons St, Dedham, MA 02026-5599 | 2010-12-22 |
| 1467756031 | Dedham Medical Associates | Clinical Medical Laboratory | 325 River Ridge Dr, Norwood, MA 02062-5027 | 2010-12-22 |
| 1831366434 | Dedham Medical Associates | Physician Assistant | 1 Lyons St, Dedham, MA 02026-5599 | 2008-05-13 |
| 1457351520 | Dedham Medical Associates | Ophthalmology | 1 Lyons St, Dedham, MA 02026-5599 | 2005-07-29 |
| 1801896972 | Dedham Medical Associates | Internal Medicine | 1 Lyons St, Dedham, MA 02026-5599 | 2005-07-29 |
| 1407856586 | Dedham Medical Associates | Dermatology | 1 Lyons St, Dedham, MA 02026-5599 | 2005-07-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | DEDHAM MEDICAL ASSOCIATES PARTNERSHIP | One Lyons Street, Dedham, MA 02026 |
| Massachusetts Corporations | DEDHAM MEDICAL ASSOCIATES, INC. | 743 High St, Dedham, MA 02026 |
| Street Address |
1 LYONS ST |
| City | DEDHAM |
| State | MA |
| Zip Code | 02026-5599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780680488 | Michael S Shusterman | Pediatrics | 1 Lyons St, Dedham, MA 02026-5599 | 2005-06-27 |
| 1760014732 | Kwai Ying Lam | Dietitian, Registered | 1 Lyons St, Dedham, MA 02026-5599 | 2020-02-07 |
| 1841857422 | Lauren Elizabeth Rogerson | Physical Therapist | 1 Lyons St, Dedham, MA 02026-5599 | 2019-05-20 |
| 1619453859 | Mathew Steven Sadowski | Physical Therapist | 1 Lyons St, Dedham, MA 02026-5599 | 2018-07-11 |
| 1689160269 | Brittany Thibodeau | Audiologist | 1 Lyons St, Dedham, MA 02026-5599 | 2018-07-06 |
| 1568964054 | Mario Fernando Jaramillo | Technician/Technologist | 1 Lyons St, Dedham, MA 02026-5599 | 2018-03-01 |
| 1902338023 | Laurie Cook | Technician/Technologist | 1 Lyons St, Dedham, MA 02026-5599 | 2017-03-29 |
| 1952858441 | Nicole Marie Ikeda | Physician Assistant | 1 Lyons St, Dept. of Dermatology, Dedham, MA 02026 | 2016-09-01 |
| 1982072153 | Atrius Health, Inc. | Dietitian, Registered | 1 Lyons St, Dedham, MA 02026-5599 | 2015-09-04 |
| 1336521319 | Michael Tanzi | Technician/Technologist | 1 Lyons St, Dedham, MA 02026-5599 | 2015-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879651 | Convenientmd LLC | Clinic/Center | 983 Boston-providence Turnpike, Dedham, MA 02026 | 2020-10-21 |
| 1497354674 | Lifetime Physical Therapy | Physical Therapist | 453 Sprague St, Dedham, MA 02026 | 2020-10-20 |
| 1164060067 | Healthy Healing Home Care Agency LLC | In Home Supportive Care | 3 Allied Dr Suite 303, Dedham, MA 02026 | 2019-12-11 |
| 1689149023 | Alyssa Michel | Counselor | 20 E Astbrook Rd, Suite 104, Dedham, MA 02026 | 2018-10-12 |
| 1467968800 | Joshua A Helm | Chiropractor | 200 Boston Providence Highway, Suite #206, Dedham, MA 02026 | 2017-12-21 |
| 1598283848 | Jason Peltier | Physical Therapist | 606 Providence Highway, Dedham, MA 02026 | 2017-09-07 |
| 1558883371 | Padme Physical Therpay | Clinic/Center | 227 Legacy Place Boulevard, Stil Studio, Dedham, MA 02026 | 2017-07-13 |
| 1851828107 | Pm Pediatrics of New England | Pediatrics | 719 Providence Highway, Dedham, NY 02026 | 2017-05-17 |
| 1740715846 | Stil Legacy Dedham | Physical Therapist | 227 Legacy Place, Dedham, MA 02026 | 2017-04-26 |
| 1053856310 | Donald Hughes | Social Worker | 270 Bridge Street, Suite 301, Dedham, MA 02026 | 2016-12-22 |
| Find all providers in zip 02026 | ||||
| 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 |
|---|---|---|---|---|
| 1497861736 | Felipe Moreno | Dentist | 1 Lyons St, Dedham, MA 02026 | 2006-08-21 |
| 1447280615 | Jay S Schwab | Dentist | One Lyons Street, Dedham, MA 02026 | 2006-07-04 |
| 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 |
| 1790254845 | Somerville Pediatric Dentistry and Orthodontics | Dentist | 51 Cross St, Somerville, MA 02145-3244 | 2018-11-19 |
| 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 |
| 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.