Beverly Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

License

20980 Issued in MA

Legal business name

BEVERLY DENTAL GROUP LLC

Practice address

16 Enon St
Beverly, MA 01915-1116

Phone

(617) 921-6292

NPI assigned

Jun 1, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Richard Miller, DMD

Title

President

Phone

(617) 921-6292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1144678012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151116",
            "telephone_number": "617-921-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151116",
            "telephone_number": "617-921-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-921-6292",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "20980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Bertolon, CPNP, RN
• Julia Constance Bertozzi, PA-C
• Beth Israel Lahey Health Primary Care, Inc.
• Samantha B Beuchert
• Beverly Dental Care PC
• Beverly Dentistry and Braces PC
• Beverly Family Chiropractic, P.C.
• Beverly Farms Dental PLLC
• Beverly Health Department Dental Clinic
• Beverly Hospital

• Dentist in Beverly, MA
• Providers in Beverly, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.