Community Dentist Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

COMMUNITY DENTIST ASSOCIATES PC

Practice address

420 Essex St
Lawrence, MA 01840-1214

Phone

(978) 691-5069

NPI assigned

Oct 23, 2023

Last updated

Oct 23, 2023By 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

Dr. Ingrid Pena, DMD

Title

Dentist

Phone

(617) 755-3850

Specialties & licenses 1

Addresses

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.

• Ingrid Pena de Carreno, DMD

  • General Practice Dentistry
  • Lawrence, MA
  • NPI 1689950420
  NPD

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1093587156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401214",
            "telephone_number": "978-691-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401214",
            "telephone_number": "978-691-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTIST ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-755-3850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lawrence, MA
• Providers in Lawrence, 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 Oct 23, 2023; 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.