ADVANCED ENDODONTIC ASSOCIATES, PC (NPI# 1477709640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477709640 |
| Entity Type | Organization |
| Organization Name | ADVANCED ENDODONTIC ASSOCIATES, PC |
| Practice Address |
39 Cross St Ste 304 Peabody MA 01960-1666 |
| Practice Telephone | 9785313400 |
| Practice Fax Number | 9785313415 |
| Mailing Telephone | 9785313400 |
| Mailing Fax Number | 9785313415 |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |
| Authorized Official Name | DR. MARK G WANG (PRESIDENT) |
| Authorized Official Telephone | 9785313400 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
20514 | MA | Dental Providers |
| Street Address |
39 CROSS ST STE 304 |
| City | PEABODY |
| State | MA |
| Zip Code | 01960-1666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020321 | Kathleen Marie Cliffe | Nurse Practitioner | 15 Sandra Rd, Peabody, MA 01960 | 2020-07-10 |
| 1801398102 | Janis Melanson | Counselor | Higgins Middle School, 85 Perkins Street, Peabody, MA 01960 | 2018-03-02 |
| 1679082036 | Kelsey Ann Lima | Social Worker | 9 Centennial Drive, Suite 202, Peabody, MA 01960 | 2017-09-28 |
| 1609394485 | Victoria Jade Olechowski | Specialist/Technologist | 1002 Crane Brook Way, Peabody, MA 01960 | 2017-08-31 |
| 1841715711 | Alexandra Lee Chasse | Counselor | 9 Cenntenial Drive, Suit 202, Peabody, MA 01960 | 2017-08-11 |
| 1275982936 | Miguel A Roque | Dentist | 6 Essex Center Drive Suite 110, Peabody, MA 01960 | 2016-06-03 |
| 1528412061 | Kabamedicalcorporation | Durable Medical Equipment & Medical Supplies | 484lowell Street, Peabody, MA 01960 | 2016-04-21 |
| 1437510815 | Ana Tereza T. Wescott | Dentist | 89 Foster Street, Peabody Family Health Center, Peabody, MA 01960 | 2016-03-14 |
| 1225496474 | Ashley Motta | Counselor | 24 Jennifer Lane, Peabody, MA 01960 | 2016-02-03 |
| 1578942645 | Cerebral Palsy of Eastern Mass Incorporated | Early Intervention Provider Agency | 6 Stratis Way, Peabody, MA 01960 | 2015-05-22 |
| Find all providers in zip 01960 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275982936 | Miguel A Roque | Dentist | 6 Essex Center Drive Suite 110, Peabody, MA 01960 | 2016-06-03 |
| 1770594905 | Richard Francis Traversy Jr. | Dentist | 125 Main St., Peabody, MA 01960 | 2006-08-11 |
| 1245642834 | Samantha Synenberg | Dentist | 6 Essex Center Dr, Suite 110, Peabody, MA 01960-2904 | 2014-05-29 |
| 1518279702 | Andrea Shah | Dentist | 6 Essex Center Dr, Suite 110, Peabody, MA 01960-2904 | 2010-07-05 |
| 1164436390 | Peter A Morgan | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-27 |
| 1821002015 | Brian Po-jen Chuang | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-27 |
| 1962416156 | Robert Rosenkranz | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-27 |
| 1114931383 | Paul Talkov | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-27 |
| 1699789842 | Harold J Levin | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-27 |
| 1902829104 | Yuri Shamritsky | Dentist | 6 Essex Center Dr, 110, Peabody, MA 01960-2910 | 2006-07-26 |
| Find all providers in PEABODY | ||||
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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.