NPIMap

Organization Active NPI

Jack and Jill Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Braintree, MA
National Provider Identifier
1184002180
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21959 Issued in MA
Legal business name
JACK AND JILL PEDIATRIC DENTISTRY, LLC
Practice address
340 Wood Rd
Suite 288
Braintree, MA 02184-2401
Phone
(617) 913-8307
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Dr. Nguyet Minh Tau, DMD
Title
Dentist/Owner
Phone
(508) 864-8997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 21959 MA Primary

Addresses

Primary practice location

340 Wood Rd
Suite 288
Braintree, MA 02184-2401

Mailing address

340 Wood Road
Suite 288
Braintree, MA 02184

National Provider Directory

National Provider Directory

Locations

340 Wood Rd
Ste 288
Braintree, MA 02184
Phone (617) 913-8307

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1184002180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 WOOD ROAD",
            "address_2": "SUITE 288",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "02184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "address_2": "SUITE 288",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401",
            "telephone_number": "617-913-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK AND JILL PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "TAU",
        "authorized_official_first_name": "NGUYET",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "508-864-8997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "21959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.