NPIMap

Organization Active NPI

Brookline Oral Surgery Group LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, MA
National Provider Identifier
1013366525
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
20980 Issued in MA
Legal business name
BROOKLINE ORAL SURGERY GROUP LLC
Practice address
500 Chapman St
Suite 201
Canton, MA 02021-2093
Phone
(617) 731-6060
NPI assigned
Jun 6, 2016
Last updated
Jun 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Richard Miller, DMDNPI 1356463665
Title
President
Phone
(617) 921-6292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 20980 MA Primary

Addresses

Primary practice location

500 Chapman St
Suite 201
Canton, MA 02021-2093

Mailing address

1223 Beacon St
Brookline, MA 02446-5302
Phone (617) 731-6060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1013366525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465302",
            "telephone_number": "617-731-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CHAPMAN ST",
            "address_2": "SUITE 201",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212093",
            "telephone_number": "617-731-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLINE ORAL SURGERY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-921-6292",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "20980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.