NPIMap

Organization Active NPI

Park Avenue Dental Associates, Inc

  • Dentist
  • Revere, MA
National Provider Identifier
1215266481
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19825 Issued in MA
Legal business name
PARK AVENUE DENTAL ASSOCIATES, INC
Practice address
500 Park Ave
Revere, MA 02151-3324
Phone
(781) 284-1177
NPI assigned
Dec 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Dr. Sherry Soleymani, DMDNPI 1033317326
Title
Dentist/Office Manager
Phone
(781) 284-1177

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19825 MA Primary

Addresses

Primary practice location

500 Park Ave
Revere, MA 02151-3324

Mailing address

500 Park Ave
Revere, MA 02151-3324
Phone (781) 284-1177

National Provider Directory

National Provider Directory

Locations

500 Park Ave
Revere, MA 02151
Phone (781) 284-1177

Practitioners & affiliated clinicians

Practitioners 2

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": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1215266481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513324",
            "telephone_number": "781-284-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513324",
            "telephone_number": "781-284-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE DENTAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "SOLEYMANI",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "DENTIST/OFFICE MANAGER",
        "authorized_official_telephone_number": "781-284-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "19825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.