NPIMap

Organization Active NPI

Brookline Denture Center, LLC

  • Dentist
  • Brookline, MA
National Provider Identifier
1134456346
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17049 Issued in MA
Legal business name
BROOKLINE DENTURE CENTER, LLC
Practice address
1842 Beacon St
Brookline, MA 02445-1930
Phone
(617) 738-1232
Fax
(617) 730-8482
NPI assigned
Nov 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Authorized official

Name
Dr. Berdj Kiladjian, D.M.D
Title
Resident Agent
Phone
(617) 738-1232

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 17049 MA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 18964 MA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 10426 MA

Addresses

Primary practice location

1842 Beacon St
Brookline, MA 02445-1930

Mailing address

1842 Beacon St
Brookline, MA 02445-1930
Phone (617) 738-1232

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1134456346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-738-1232",
            "fax_number": "617-730-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451930",
            "telephone_number": "617-738-1232",
            "fax_number": "617-730-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLINE DENTURE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "KILADJIAN",
        "authorized_official_first_name": "BERDJ",
        "authorized_official_title_or_position": "RESIDENT AGENT",
        "authorized_official_telephone_number": "617-738-1232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "17049",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18964",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "10426",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Nov 9, 2009; 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.