NPIMap

Organization Active NPI

Lexington Smile Studio, PC

  • Prosthodontics
  • Lexington, MA
National Provider Identifier
1154818359
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
LEXINGTON SMILE STUDIO, PC
Practice address
922 Waltham St Ste 202
Lexington, MA 02421-8019
Phone
(781) 861-7645
NPI assigned
Apr 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Alaaeddin Alwazzan, DMDNPI 1871705913
Title
President
Phone
(617) 669-9839

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: 193200000X MULTI-SPECIALTY GROUP 1223P0700X Primary

Addresses

Primary practice location

922 Waltham St Ste 202
Lexington, MA 02421-8019

Mailing address

500 Atlantic Ave Unit 14K
Boston, MA 02210-2245
Phone (176) 699-8396

Other names 1

  • Lexington Smile Studio Former legal business name

National Provider Directory

National Provider Directory

Locations

922 Waltham St
Ste 202
Lexington, MA 02421
Phone (781) 861-6008

Practitioners & affiliated clinicians

Practitioners 1

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": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1154818359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ATLANTIC AVE UNIT 14K",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102245",
            "telephone_number": "176-699-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WALTHAM ST STE 202",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218019",
            "telephone_number": "781-861-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON SMILE STUDIO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "ALWAZZAN",
        "authorized_official_first_name": "ALAAEDDIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-669-9839",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lexington Smile Studio",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.