NPIMap

Organization Active NPI

West Broadway Family Dental, LLC

  • General Practice Dentistry
  • South Boston, MA
National Provider Identifier
1194017871
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855380 Issued in MA
Legal business name
WEST BROADWAY FAMILY DENTAL, LLC
Practice address
385 West Broadway
South Boston, MA 02127
Phone
(617) 268-8242
NPI assigned
May 12, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Garima Rana
Title
Member
Phone
(646) 287-6946

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

385 W Broadway
South Boston, MA 02127
Phone (617) 268-8242

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1855380 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

385 West Broadway
South Boston, MA 02127

Mailing address

385 West Broadway
South Boston, MA 02127

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 12, 2011.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1194017871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 WEST BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "02127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 WEST BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "02127",
            "telephone_number": "617-268-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BROADWAY FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "RANA",
        "authorized_official_first_name": "GARIMA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "646-287-6946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.