Organization Active NPI

Burlington Oral and Facial Surgery Center LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burlington, MA
National Provider Identifier
1003251398
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN1855832 Issued in MA
Legal business name
BURLINGTON ORAL AND FACIAL SURGERY CENTER LLC
Practice address
77 S Bedford St
Suite 100
Burlington, MA 01803-5115
Phone
(781) 272-0800
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Authorized official

Name
Dr. Christopher G Pace, DMDNPI 1184678930
Title
Owner
Phone
(781) 272-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DN1855832 MA Primary

Addresses

Primary practice location

77 S Bedford St
Suite 100
Burlington, MA 01803-5115

Mailing address

77 South Bedford Street
Suite 100
Burlington, MA 01803
Phone (781) 272-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140623001524 MA Part B Supplier - Clinic/Group Practice 2264656859 Receives reassigned benefits from 5 practitioners
Practice locations: Burlington, MA; Cambridge, MA

National Provider Directory

National Provider Directory

Locations

77 S Bedford St
Ste 100
Burlington, MA 01803
Phone (781) 272-0800

625 Mount Auburn St
#205
Cambridge, MA 02138
Phone (617) 468-3100

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1003251398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SOUTH BEDFORD STREET",
            "address_2": "SUITE 100",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01803",
            "telephone_number": "781-272-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 S BEDFORD ST",
            "address_2": "SUITE 100",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035115",
            "telephone_number": "781-272-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON ORAL AND FACIAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-272-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1855832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.