NPIMap

Organization Active NPI

Restore Dental Aesthetics, PLLC

  • Dental Clinic/Center
  • Peabody, MA
National Provider Identifier
1306630264
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RESTORE DENTAL AESTHETICS, PLLC
Practice address
288 Washington St
Peabody, MA 01960-5853
Phone
(857) 389-4188
NPI assigned
Apr 7, 2025
Last updated
Apr 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Stephanie M Souza, DMDNPI 1205680188
Title
Doctor/Owner
Phone
(617) 301-3628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

288 Washington St
Peabody, MA 01960-5853

Mailing address

288 Washington St
Peabody, MA 01960-5853
Phone (617) 301-3628

National Provider Directory

National Provider Directory

Locations

288 Washington St
Peabody, MA 01960
Phone (857) 389-4188

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1306630264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 WASHINGTON ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605853",
            "telephone_number": "617-301-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 WASHINGTON ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605853",
            "telephone_number": "857-389-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE DENTAL AESTHETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "617-301-3628",
        "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 Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.