DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC (NPI# 1700387453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700387453 |
| Entity Type | Organization |
| Organization Name | DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC |
| Practice Address |
1192 Blue Hill Ave Unit 1192 Boston MA 02126-1819 |
| Mailing Address |
8 Brighton St Apt 3 Charlestown MA 02129-1260 |
| Practice Telephone | 6175017773 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | VANDANA SONI (PRESIDENT) |
| Authorized Official Telephone | 6175017773 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN21051 | MA | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DN21679 | MA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN20698 | MA | Dental Providers |
| Street Address |
1192 BLUE HILL AVE UNIT 1192 |
| City | BOSTON |
| State | MA |
| Zip Code | 02126-1819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280646 | Covil Home Care LLC | In Home Supportive Care | 1549 Blue Hill Ave, Mattapan, MA 02126 | 2019-05-10 |
| 1902374069 | Kasha Sarette | Social Worker | 37 Babson St, Mattapan, MA 02126 | 2018-11-07 |
| 1093231359 | Danielle Christian | Behavior Technician | 73 Catbird Ct, Mattapan, MA 02126 | 2017-08-18 |
| 1609314681 | Regis College | Hospice, Inpatient | 19 Southmere Road, Mattapan, MA 02126 | 2017-02-09 |
| 1437606001 | Betsy-lynn Ngole | Community Health Worker | 137 Savannah Ave, Boston, MA 02126 | 2016-09-01 |
| 1437535440 | Rosel Forwang Lewis | Registered Nurse | 42 Hallowell St, Mattapan, MA 02126 | 2015-08-03 |
| 1033596895 | Quality Home Care & Transportation | Transportation Broker | 93 W Selden St, Mattapan, MA 02126 | 2015-04-30 |
| 1205101565 | Clayton Mark Sandiford | Contractor | 22 Banfield Ave, Boston, MA 02126 | 2012-03-19 |
| 1790093128 | Richard Christopher Mitchell Jr. | Counselor | 32 Wellington Hill St, Mattapan, MA 02126 | 2010-09-20 |
| 1972630622 | Gemima St. Louis | Psychologist | 255 River St, Spark Center-bmc, Mattapan, MA 02126 | 2007-02-28 |
| Find all providers in zip 02126 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1730660903 | Matthew Brian Harper | Dentist | 300 Longwood Ave Fl 4, Boston, MA 02115-5724 | 2018-08-27 |
| 1710487079 | Huw F Thomas | Dentist | 1 Kneeland St Rm 749, Boston, MA 02111-1527 | 2018-02-13 |
| 1023539269 | Altan Kihm | Dentist | 1 Keeland St, Boston, MA 02111 | 2017-06-28 |
| 1902287915 | Nour Gowharji | Dentist | 1 Kneeland Street, Tufts School of Dental Medicine., 8th Floor, Room 842, Boston, MA 02111 | 2015-06-16 |
| 1063824464 | Maria Al Ismail | Dentist | 635 Albany St, Boston, MA 02118-2308 | 2014-05-20 |
| 1225449341 | Sara Ahmed | Dentist | 300 Longwood Ave Dental Department, Boston, MA 02115 | 2014-05-12 |
| 1952731549 | Boston University Henry M. Goldman School of Dental Medicine | Dentist | 100 E Newton St # G-200, Boston, MA 02118-2308 | 2013-11-18 |
| 1134387962 | Sungyon Bang | Dentist | 300 Longwood Ave # Hu-226, Childrens Hospital Boston Dental Department, Boston, MA 02115-5724 | 2008-05-29 |
| Find all providers in BOSTON | ||||
Please comment or provide details below to improve the information on DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC.
| 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.