NPIMap

Organization Active NPI

Pediatric Dental Associates of Brookline, PC

  • Pediatric Dentistry
  • Brookline, MA
National Provider Identifier
1144369109
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12246 Issued in MA
Legal business name
PEDIATRIC DENTAL ASSOCIATES OF BROOKLINE, PC
Practice address
1684 Beacon St
Brookline, MA 02445-2101
Phone
(617) 232-7100
NPI assigned
Feb 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
John Ficarelli, DMDNPI 1407817141
Title
Owner
Phone
(617) 232-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12246 MA Primary

Addresses

Primary practice location

1684 Beacon St
Brookline, MA 02445-2101

Mailing address

1684 Beacon St
Brookline, MA 02445-2101
Phone (617) 232-7100

National Provider Directory

National Provider Directory

Locations

1684 Beacon St
Brookline, MA 02445
Phone (617) 232-7100

Practitioners & affiliated clinicians

Practitioners 4

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144369109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452101",
            "telephone_number": "617-232-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452101",
            "telephone_number": "617-232-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF BROOKLINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FICARELLI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-232-7100",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "12246",
            "primary": true
        }
    ],
    "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 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.