COREDENTAL, LLC (NPI# 1750828752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750828752 |
| Entity Type | Organization |
| Organization Name | COREDENTAL, LLC |
| Practice Address |
611 Adams St Quincy MA 02169-1319 |
| Practice Telephone | 6174799191 |
| Practice Fax Number | 6174816635 |
| Mailing Telephone | 6176515255 |
| Mailing Fax Number | 6174816635 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-05-04 |
| Authorized Official Name | DR. FREDERICK NAFASH (SOLE MEMBER) |
| Authorized Official Telephone | 6176349393 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN1856376 | MA | Dental Providers |
| Street Address |
611 ADAMS ST |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-1319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841441649 | Frederick F Nafash | Dentist | 611 Adams St, Quincy, MA 02169-1319 | 2008-10-10 |
| 1487920880 | Premier Dental of Quincy | Dentist | 611 Adams St, Quincy, MA 02169-1319 | 2012-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518267525 | Khanh Xuan Le | Dentist | 66 Mayor Thomas J Mcgrath Hwy, Quincy, MA 02169-5347 | 2010-10-25 |
| 1962720219 | Sandra Morin | Dentist | 1372 Hancock Street 204, Quincy, MA 02169 | 2010-05-12 |
| 1841441649 | Frederick F Nafash | Dentist | 611 Adams St, Quincy, MA 02169-1319 | 2008-10-10 |
| 1295916948 | David Darwin Wright | Dentist | 1200 Hampshire St, Quincy, IL 62301-3109 | 2007-11-23 |
| 1518158591 | Carlos Abboud | Dentist | 333 Ricciuti Dr., Suite 1003, Quincy, MA 02169 | 2007-08-06 |
| 1588854384 | Mohamed Hassan | Dentist | 858 E Squantum St, Quincy, MA 02171-1227 | 2007-07-27 |
| 1942721063 | Yolanda Ho | Dentist | 505 Washington St, Quincy, MA 02169-5834 | 2017-06-28 |
| 1649430422 | Yi Julia Yang | Dentist | 24 Adams St, Quincy, MA 02169-2018 | 2008-06-14 |
| 1710177696 | Excell Family Dental, PC | Dentist | 1261 Furnace Brook Pkwy, #24, Quincy, MA 02169-4721 | 2007-07-27 |
| 1548321235 | Italo Lozada | Dentist | 1518 Hancock St, Quincy, MA 02169-5205 | 2006-12-13 |
| Find all providers in QUINCY | ||||
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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.