NPIMap

Organization Active NPI

Randolph Family Dentistry PC

  • Dentist
  • Randolph, MA
National Provider Identifier
1184155590
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20104 Issued in MA
Legal business name
RANDOLPH FAMILY DENTISTRY PC
Practice address
56 S Main St
Randolph, MA 02368-4861
Phone
(781) 963-0860
NPI assigned
Mar 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Authorized official

Name
Dr. Eyad Salloum, DMD
Title
Dentist
Phone
(781) 963-0860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 20104 MA Primary

Addresses

Primary practice location

56 S Main St
Randolph, MA 02368-4861

Mailing address

3 LT Anderson Dr
Foxboro, MA 02035-1372
Phone (617) 462-8728

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1184155590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LT ANDERSON DR",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020351372",
            "telephone_number": "617-462-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 S MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684861",
            "telephone_number": "781-963-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "SALLOUM",
        "authorized_official_first_name": "EYAD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-963-0860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "20104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.