Nedg Wilmington

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NEDG WILMINGTON

Practice address

206 Ballardvale St
Wilmington, MA 01887-1044

Phone

(508) 962-2332

NPI assigned

Nov 7, 2018

Last updated

Jun 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gokulan Thiagarajah

Title

Director/Owner

Phone

(508) 962-2332

Specialties & licenses 1

Addresses

Other names 1

• New England Dental Group Former legal business name

Locations

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1023586062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 TURNPIKE RD STE 330",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721791",
            "telephone_number": "508-281-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BALLARDVALE ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871044",
            "telephone_number": "508-962-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEDG WILMINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "THIAGARAJAH",
        "authorized_official_first_name": "GOKULAN",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "508-962-2332",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New England Dental Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kristina Murray, PT
• Anna Jessica Musialowski, PA-C
• Junior Smith Mutchapa
• Jessica Napoli
• Caitlin Heather Nearing, PHARMD
• Neighborhood Therapy LLC
• Gayathry Sooriyakumar Nene, D.O
• Bich Van Thi Nguyen
• Holly T Nguyen, PAC
• Jasmine A Nguyen

• General Practice Dentistry in Wilmington, MA
• Providers in Wilmington, 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 Jun 29, 2022; 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.