NPIMap

Organization Active NPI

Celestial Smile Dental Associates - Ma PC

  • General Practice Dentistry
  • Roxbury, MA
National Provider Identifier
1316590839
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CELESTIAL SMILE DENTAL ASSOCIATES - MA PC
Practice address
376 Warren St
Roxbury, MA 02119-1830
Phone
(781) 774-9885
NPI assigned
Jul 23, 2019
Last updated
Jul 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Dr. Anthony O Olatunji, DMDNPI 1932267390
Title
Dentist-President
Phone
(781) 774-9885

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
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

376 Warren St
Roxbury, MA 02119-1830

Mailing address

376 Warren St
Roxbury, MA 02119-1830
Phone (781) 774-9885

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL celestialrox29@gmail.com Other

National Provider Directory

National Provider Directory

Locations

376 Warren St
Roxbury, MA 02119
Phone (617) 442-3400

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": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1316590839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 WARREN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191830",
            "telephone_number": "781-774-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 WARREN ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191830",
            "telephone_number": "781-774-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELESTIAL SMILE DENTAL ASSOCIATES - MA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "OLATUNJI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DENTIST-PRESIDENT",
        "authorized_official_telephone_number": "781-774-9885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "celestialrox29@gmail.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "376 Warren St",
            "city": "Roxbury",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021191830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.