CAMBRIDGE CHILDREN'S DENTISTRY PC (NPI# 1578823902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578823902 |
| Entity Type | Organization |
| Organization Name | CAMBRIDGE CHILDREN'S DENTISTRY PC |
| Practice Address |
575 Mount Auburn St Suite 201 Cambridge MA 02138-4656 |
| Practice Telephone | 6173834356 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |
| Authorized Official Name | PEDRAM JAVEDAN (PRESIDENT) |
| Authorized Official Telephone | 6173834356 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN1855617 | MA | Dental Providers |
| Street Address |
575 MOUNT AUBURN ST SUITE 201 |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-4656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801890835 | Michael William Yogman | Pediatrics | 575 Mount Auburn St, Ste 202, Cambridge, MA 02138-4627 | 2005-06-08 |
| 1770139255 | Aimee Johnson Moreno | Counselor | 575 Mount Auburn St, Cambridge, MA 02138-4656 | 2019-08-12 |
| 1295110492 | Cara Ilene Kimberg | Psychologist | 575 Mount Auburn St, #101, Cambridge, MA 02138-4656 | 2015-07-29 |
| 1760814545 | Susan Betjemann | Social Worker | 575 Mount Auburn St, Suite 202, Cambridge, MA 02138-4656 | 2013-08-05 |
| 1063854693 | Aislyn Cangialose | Nurse Practitioner | 575 Mount Auburn St, Suite 101, Cambridge, MA 02138-4656 | 2013-07-24 |
| 1710136098 | Robyn L. Glover | Psychologist | 575 Mount Auburn St, Suite 101, Cambridge, MA 02138-4656 | 2008-09-11 |
| 1417136789 | Marni Roitfarb | Pediatrics | 575 Mount Auburn St, Suite 202, Cambridge, MA 02138-4656 | 2007-11-02 |
| 1821295452 | Pedram Javedan | Dentist | 575 Mount Auburn St, Suite 201, Cambridge, MA 02138-4656 | 2007-06-28 |
| 1477676674 | Cindy Fischer Luthern | Nurse Practitioner | 575 Mount Auburn St, Suite 101 Epstein, Ballenger, Goldstein, Cambridge, MA 02138-4656 | 2007-04-10 |
| 1487794814 | West Cambridge Pediatric & Adolescent Medicin, PC | Health Maintenance Organization | 575 Mount Auburn St, Cambridge, MA 02138-4656 | 2007-02-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
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| 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 |
|---|---|---|---|---|
| 1093065179 | Gulsun Gul | Dentist | 245 1st St, 17th Floor, Cambridge, MA 02142-1200 | 2012-09-14 |
| 1790077857 | Hubert J Park | Dentist | 80 Fawcett St Unit 252, Cambridge, MA 02138-1151 | 2011-05-09 |
| 1265583348 | George Wellington Mceachern IIi | Dentist | 1749 Massachusetts Ave, Cambridge, MA 02140-2217 | 2007-01-15 |
| 1316957962 | Ronald W Smith | Dentist | 1749 Mass Ave, Cambridge, MA 02140 | 2006-08-08 |
| 1003229543 | Fatima Pirzada Aziz | Dentist | 1749 Massachusetts Ave, Cambridge, MA 02140 | 2014-06-03 |
| 1265751937 | Usman Shaukat Ali | Dentist | 503 Muir St Ste A, Cambridge, MD 21613-1848 | 2010-05-20 |
| 1871743187 | Ronald W. Smith, D.d.s., P.C. | Dentist | 1749 Massachusetts Ave, Cambridge, MA 02140-2217 | 2008-09-23 |
| 1821295452 | Pedram Javedan | Dentist | 575 Mount Auburn St, Suite 201, Cambridge, MA 02138-4656 | 2007-06-28 |
| 1710030986 | Cambridge Pediatric Dental Associates, P.C. | Dentist | 1749 Massachusetts Ave, Cambridge, MA 02140-2217 | 2007-01-19 |
| 1417009796 | Sara Louise Filstrup | Dentist | 1749 Massachusetts Ave, Cambridge, MA 02140-2217 | 2007-01-17 |
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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.