Organization Active NPI

North Cambridge Dental, P.C.

  • General Practice Dentistry
  • Cambridge, MA
National Provider Identifier
1235251695
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14418 Issued in MA
Legal business name
NORTH CAMBRIDGE DENTAL, P.C.
Practice address
2210 Massachusetts Ave
Cambridge, MA 02140-1892
Phone
(617) 876-8636
Fax
(617) 661-4894
NPI assigned
Apr 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Loren Jay Wilson, D.M.D.
Title
President
Phone
(617) 876-8636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14418 MA Primary

Addresses

Primary practice location

2210 Massachusetts Ave
Cambridge, MA 02140-1892

Mailing address

2210 Massachusetts Ave
Cambridge, MA 02140-1892
Phone (617) 876-8636

National Provider Directory

National Provider Directory

Locations

2210 Massachusetts Ave
Cambridge, MA 02140
Phone (617) 876-8636

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235251695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401892",
            "telephone_number": "617-876-8636",
            "fax_number": "617-661-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401892",
            "telephone_number": "617-876-8636",
            "fax_number": "617-661-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAMBRIDGE DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-876-8636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.