Active NPI
Charles C Hur, DMD
- General Practice Dentistry
- Lexington, MA
National Provider Identifier
1285854505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17777
- Practice address
- 57 Bedford Street
Suite 205 Icon DPMG LLC Dba Icon Dental
Lexington, MA 02420 - Phone
- (781) 861-6401
- Fax
- (781) 861-6258
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17777 | MA | Primary |
Addresses
Primary practice location
57 Bedford Street
Suite 205 Icon DPMG LLC Dba Icon Dental
Lexington, MA 02420
Mailing address
57 Bedford Street
Lexington, MA 02420
Phone (781) 861-6401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17777 | MA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285854505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 BEDFORD STREET",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "02420",
"telephone_number": "781-861-6401",
"fax_number": "781-861-6258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 BEDFORD STREET",
"address_2": "SUITE 205 ICON DPMG LLC DBA ICON DENTAL",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "02420",
"telephone_number": "781-861-6401",
"fax_number": "781-861-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUR",
"first_name": "CHARLES",
"middle_name": "C",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "17777",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.