NPIMap

Organization Active NPI

Salem Dental Group LLC

  • Dentist
  • Salem, MA
National Provider Identifier
1104361948
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20980 Issued in MA
Legal business name
SALEM DENTAL GROUP LLC
Practice address
393 Essex St
Salem, MA 01970-3156
Phone
(978) 744-5912
NPI assigned
Jan 4, 2017
Last updated
Jan 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Authorized official

Name
Richard T MillerNPI 1356463665
Title
Sole Member
Phone
(617) 921-6292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN20980 MA Primary

Addresses

Primary practice location

393 Essex St
Salem, MA 01970-3156

Mailing address

500 Chapman St Unit 201
Canton, MA 02021-2040

National Provider Directory

National Provider Directory

Locations

500 Chapman St
Unit 201
Canton, MA 02021
Phone (617) 731-6060

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1104361948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHAPMAN ST UNIT 201",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 ESSEX ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703156",
            "telephone_number": "978-744-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "617-921-6292"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN20980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.