NPIMap

Organization Active NPI

42 North Dental Care, LLC

  • Dental Clinic/Center
  • Needham, MA
National Provider Identifier
1124592951
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL CARE, LLC
Practice address
1211 Highland Ave
Needham, MA 02492-2634
Phone
(781) 647-0772
NPI assigned
Jan 15, 2019
Organization subpart
Yes
Parent organization
42 NORTH DENTAL CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Dr. Michael Angelo Scialabba, DDS
Title
Chief Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1211 Highland Ave
Needham, MA 02492-2634

Mailing address

200 5TH Ave FL 3
Waltham, MA 02451-8759
Phone (781) 647-0772

Other names 1

  • Gillis Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Care LLC54 organizations share this tax ID, including this one
Part of
42 North Dental Care LLC

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1124592951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 5TH AVE FL 3",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518759",
            "telephone_number": "781-647-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922634",
            "telephone_number": "781-647-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "42 NORTH DENTAL CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL CARE, LLC",
        "enumeration_date": "2019-01-15",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANGELO",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gillis Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gillis Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.