Immediate Dental Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

DN1855283 Issued in MA

Legal business name

IMMEDIATE DENTAL INC.

Practice address

127 High St
Clinton, MA 01510-2510

Phone

(978) 875-5171

Fax

(888) 599-1916

NPI assigned

Jun 2, 2016

Organization subpart

No

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

Authorized official

Name

Thanh Pham, DMD

Title

Manager

Phone

(978) 875-5171

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1013365857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 HIGH ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015102510",
            "telephone_number": "978-875-5171",
            "fax_number": "888-599-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 HIGH ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015102510",
            "telephone_number": "978-875-5171",
            "fax_number": "888-599-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "THANH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "978-875-5171",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Clinton, MA
• Providers in Clinton, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.