Phuongdao DMD LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17573 Issued in MA

Legal business name

PHUONGDAO DMD LLC

Practice address

910 Broadway FL 1
Everett, MA 02149-3126

Phone

(617) 389-8317

NPI assigned

May 18, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Phuong Thi Dao, D.M.DNPI 1124223755

Title

Owner

Phone

(617) 389-8317

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phuong Thi Dao, DMD

  • General Practice Dentistry
  • Everett, MA
  • NPI 1124223755
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1003176512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BROADWAY FL 1",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493126",
            "telephone_number": "617-389-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BROADWAY FL 1",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493126",
            "telephone_number": "617-389-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHUONGDAO DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "DAO",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-389-8317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X06225",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276685",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory John Pennline
• Jean E Perez
• Nicole Perez
• Dorinda E. Perkins, M.S., PSYCHOLOGY
• Peter E Masucci, MD, PC
• Physician Coverage Services
• Jonathan David Pierce, DO
• Cassandre Pierre Louis
• Ashley Aline Pierre
• Francine Pierre

• General Practice Dentistry in Everett, MA
• Providers in Everett, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.