NPIMap

Organization Active NPI

Cambridge Dental Annex

  • Dental Clinic/Center
  • Cambridge, MA
National Provider Identifier
1033363395
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
17123 Issued in MA
Legal business name
CAMBRIDGE DENTAL ANNEX
Practice address
897 Massachusetts Ave
Cambridge, MA 02139-3045
Phone
(617) 871-1482
Fax
(617) 871-1484
NPI assigned
Nov 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Authorized official

Name
Dr. Carol K YunNPI 1366504672
Title
Dentist/Owner
Phone
(617) 871-1482

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
Dental Clinic/Center 261QD0000X 17123 MA Primary

Addresses

Primary practice location

897 Massachusetts Ave
Cambridge, MA 02139-3045

Mailing address

897 Massachusetts Ave
Cambridge, MA 02139-3045
Phone (617) 871-1482

National Provider Directory

National Provider Directory
Tax ID family
Cambridge Dental Annex2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

897 Massachusetts Ave
Cambridge, MA 02139
Phone (617) 871-1482

Practitioners & affiliated clinicians

Practitioners 3

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": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1033363395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393045",
            "telephone_number": "617-871-1482",
            "fax_number": "617-871-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393045",
            "telephone_number": "617-871-1482",
            "fax_number": "617-871-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE DENTAL ANNEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "YUN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "617-871-1482",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "17123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.