NPIMap

Organization Active NPI

Medford Square Dentistry and Implants LLC

  • Dental Clinic/Center
  • Medford, MA
National Provider Identifier
1295400588
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MEDFORD SQUARE DENTISTRY AND IMPLANTS LLC
Practice address
30 Main St
Medford, MA 02155-7102
Phone
(781) 391-2440
NPI assigned
Aug 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Ram P Yadav, DMDNPI 1972117414
Title
Dentist
Phone
(573) 639-0497

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

30 Main St
Medford, MA 02155-7102

Mailing address

20 Summer St Apt 903
Malden, MA 02148-3914
Phone (573) 639-0497

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1295400588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SUMMER ST APT 903",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021483914",
            "telephone_number": "573-639-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021557102",
            "telephone_number": "781-391-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD SQUARE DENTISTRY AND IMPLANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "YADAV",
        "authorized_official_first_name": "RAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-639-0497",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.