NPIMap

Organization Active NPI

Poonam Soi DMD LLC

  • General Practice Dentistry
  • Waltham, MA
National Provider Identifier
1174046684
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1856498 Issued in MA
Legal business name
POONAM SOI DMD LLC
Doing business as
376 Dental Studio
Practice address
376 Moody St
Waltham, MA 02453-5204
Phone
(206) 949-7622
NPI assigned
Jul 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Authorized official

Name
Poonam Soi, DMDNPI 1699054676
Title
Owner/General Dentist
Phone
(206) 949-7622

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1856498 MA Primary

Addresses

Primary practice location

376 Moody St
Waltham, MA 02453-5204

Mailing address

160 Cambridgepark Drive Apt 359
Cambridge, MA 02140
Phone (206) 949-7622

Other names 1

  • 376 Dental Studio Doing business as

National Provider Directory

National Provider Directory

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": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1174046684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CAMBRIDGEPARK DRIVE APT 359",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02140",
            "telephone_number": "206-949-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 MOODY ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535204",
            "telephone_number": "206-949-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POONAM SOI DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "SOI",
        "authorized_official_first_name": "POONAM",
        "authorized_official_title_or_position": "OWNER/GENERAL DENTIST",
        "authorized_official_telephone_number": "206-949-7622",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "376 Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "376 Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.