Brookline Oral Surgery Group LLC

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

Organization subpart

No

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

Authorized official

Name

Richard Miller, DMD

Title

President

Phone

(617) 921-6292

Specialties & licenses 1

Addresses

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": []
}

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• Caroline J Brinkert, M.S., CCC-SLP
• Lauren Elizabeth Brittan, RDH
• Emily Brown
• Jennifer Brown
• John A Brown, PH.D.
• Rebecca Brown
• Kayla Bruccoleri, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Canton, MA
• Providers in Canton, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• 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.