NPIMap

Organization Active NPI

Northeast Dental Associates

  • General Practice Dentistry
  • Brookline, MA
National Provider Identifier
1124240783
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9772 Issued in MA
Legal business name
NORTHEAST DENTAL ASSOCIATES
Practice address
1842 Beacon Street
Suite 302
Brookline, MA 02445-1930
Phone
(617) 730-8989
Fax
(617) 730-8913
NPI assigned
May 3, 2007
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
Dr. Herbert S Yolin, DDS
Title
Owner
Phone
(617) 730-8989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9772 MA Primary

Addresses

Primary practice location

1842 Beacon Street
Suite 302
Brookline, MA 02445-1930

Mailing address

1842 Beacon Street
Suite 302
Brookline, MA 02445-1930
Phone (617) 730-8989

Other identifiers 1

IdentifierTypeStateIssuer
Y51489OtherMABCBS OF MA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124240783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 BEACON STREET",
            "address_2": "SUITE 302",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-730-8989",
            "fax_number": "617-730-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 BEACON STREET",
            "address_2": "SUITE 302",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-730-8989",
            "fax_number": "617-730-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOLIN",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-730-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "9772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "Y51489",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, 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.