Pine Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PINE DENTAL PC

Practice address

394 Water St
Fitchburg, MA 01420-5602

Phone

(617) 888-3400

NPI assigned

Apr 1, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Dong Won Kim, DMD

Title

Owner

Phone

(617) 888-3400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1245081736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "394 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205602",
            "telephone_number": "617-888-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205602",
            "telephone_number": "617-888-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "394 Water St",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014205602",
            "country_code": "US",
            "telephone_number": "617-888-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONG",
        "authorized_official_middle_name": "WON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-888-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Tulonen Pierce, M.ED.
• Carline Pierre
• Dieulila Vil Pierre
• Dennis Pikul
• Cassandra Pillsbury
• Lisa A. Pineo, L.M.H.C.
• Pinnacle Medical Supply
• La-Keisha Renee Pinnock, N.P.
• Tracy Pinnock, RN,BSN
• Lynne Pochesci

• Dental Clinic/Center in Fitchburg, MA
• Providers in Fitchburg, 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 Apr 1, 2024; 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.