NPIMap

Organization Active NPI

Parkway Dental LLC

  • Dentist
  • Roslindale, MA
National Provider Identifier
1154664027
Registry record updated Mar 29, 2013
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18174 Issued in MA
Legal business name
PARKWAY DENTAL LLC
Practice address
893 South St
Roslindale, MA 02131-2411
Phone
(617) 323-3443
Fax
(617) 323-3350
NPI assigned
Mar 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2013

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

Authorized official

Name
Dr. Ramesh Izedian, D.M.D.
Title
Owner
Phone
(508) 676-8268

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18174 MA Primary

Addresses

Primary practice location

893 South St
Roslindale, MA 02131-2411

Mailing address

893 South St
Roslindale, MA 02131-2411
Phone (617) 323-3443

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364515200000",
    "number": "1154664027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 SOUTH ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312411",
            "telephone_number": "617-323-3443",
            "fax_number": "617-323-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 SOUTH ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312411",
            "telephone_number": "617-323-3443",
            "fax_number": "617-323-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-29",
        "last_updated": "2013-03-29",
        "status": "A",
        "authorized_official_last_name": "IZEDIAN",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-676-8268",
        "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": "18174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.