NPIMap

Organization Active NPI

Lawrence L. Phan, DMD, PC

  • Prosthodontics
  • Brookline, MA
National Provider Identifier
1154627180
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
16254 Issued in MA
Legal business name
LAWRENCE L. PHAN, DMD, PC
Practice address
1330 Beacon St
Suite 353
Brookline, MA 02446-3282
Phone
(617) 734-6300
Fax
(617) 734-2732
NPI assigned
Feb 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Dr. Lawrence Luan Phan, D.M.D.NPI 1083620819
Title
Ceo
Phone
(617) 734-6300

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
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X 16254 MA Primary

Addresses

Primary practice location

1330 Beacon St
Suite 353
Brookline, MA 02446-3282

Mailing address

1330 Beacon St
Suite 353
Brookline, MA 02446-3282
Phone (617) 734-6300

National Provider Directory

National Provider Directory

Locations

1330 Beacon St
Ste 353
Brookline, MA 02446
Phone (617) 734-6300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1154627180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "address_2": "SUITE 353",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463282",
            "telephone_number": "617-734-6300",
            "fax_number": "617-734-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "address_2": "SUITE 353",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463282",
            "telephone_number": "617-734-6300",
            "fax_number": "617-734-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE L. PHAN, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "LUAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-734-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "16254",
            "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 Feb 9, 2011; 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.