NPIMap

Organization Active NPI

Eagle Endodontics, Inc

  • Endodontics
  • Lexington, MA
National Provider Identifier
1215379375
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
21378 Issued in MA
Legal business name
EAGLE ENDODONTICS, INC
Practice address
19 Muzzey St
210
Lexington, MA 02421-5256
Phone
(781) 863-2453
NPI assigned
Jul 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Authorized official

Name
Ali Sarraf, DMDNPI 1720295991
Title
President
Phone
(617) 767-4829

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 21378 MA Primary

Addresses

Primary practice location

19 Muzzey St
210
Lexington, MA 02421-5256

Mailing address

108 4TH St
Medford, MA 02155-5018
Phone (617) 767-4829

National Provider Directory

National Provider Directory

Locations

19 Muzzey St
Ste 210
Lexington, MA 02421
Phone (781) 861-7777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1215379375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 4TH ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555018",
            "telephone_number": "617-767-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MUZZEY ST",
            "address_2": "210",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024215256",
            "telephone_number": "781-863-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ENDODONTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "SARRAF",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-767-4829",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "21378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.