Simply Dental and Orthodontics of Wayland ,PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN20511 Issued in MA

Legal business name

SIMPLY DENTAL AND ORTHODONTICS OF WAYLAND ,PLLC

Practice address

21 Elissa Ave
Wayland, MA 01778-3154

Phone

(508) 589-8270

Fax

(508) 435-2690

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Aimee Hodgerney

Title

Operations Manager

Phone

(508) 589-8270

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1225517899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 ELM ST STE 302",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481638",
            "telephone_number": "508-589-8270",
            "fax_number": "508-435-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ELISSA AVE",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017783154",
            "telephone_number": "508-589-8270",
            "fax_number": "508-435-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY DENTAL AND ORTHODONTICS OF WAYLAND ,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "HODGERNEY",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "508-589-8270"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "DN20511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Warner Shackleton, ED.D.
• Natalie Gina Shahin, RPH
• Brian Francis Shaughnessy, D.M.D.
• Matthew Shear, OD
• Joann Simon, LIC.AC., RD, LDN
• Regina Perry Siu, APRN
• Robin Sklar, OTR/L, CHT
• Elizabeth Trace Slater, PH.D.
• Diane Marie Smith, P.T.A.
• Jonathan G Smith, M.D.

• Dental Clinic/Center in Wayland, MA
• Providers in Wayland, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.