NPIMap

Organization Active NPI

John D Meola, D.D.S., P.C.

  • Dentist
  • Waltham, MA
National Provider Identifier
1063513869
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14230 Issued in MA
Legal business name
JOHN D MEOLA, D.D.S., P.C.
Practice address
40 2ND Ave
Suite 500
Waltham, MA 02451-1132
Phone
(781) 890-4900
Fax
(781) 890-6094
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kathleen Ann Russell
Title
Business Manager
Phone
(781) 890-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 14230 MA Primary

Addresses

Primary practice location

40 2ND Ave
Suite 500
Waltham, MA 02451-1132

Mailing address

40 2ND Ave
Suite 500
Waltham, MA 02451-1132
Phone (781) 890-4900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063513869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 2ND AVE",
            "address_2": "SUITE 500",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511132",
            "telephone_number": "781-890-4900",
            "fax_number": "781-890-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 2ND AVE",
            "address_2": "SUITE 500",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511132",
            "telephone_number": "781-890-4900",
            "fax_number": "781-890-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D MEOLA, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "781-890-4900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "14230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.