Northeastern Pediatric Dental

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3374 Issued in NH

Legal business name

NORTHEASTERN PEDIATRIC DENTAL

Practice address

78 Northeastern Blvd
Suite 6
Nashua, NH 03062

Phone

(603) 880-5002

Fax

(603) 880-1877

NPI assigned

Feb 20, 2008

Organization subpart

Yes

Parent organization

NORTHEASTERN PEDIATRIC DENTALAs reported in NPPES

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

Authorized official

Name

Mina H Kalali, DMDNPI 1205962396

Title

DMD Owner

Phone

(603) 880-5002

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Northeastern Pediatric Dental

Locations

Practitioners 1

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

• Mina Hojabr Kalali, DMD

  • Pediatric Dentistry
  • Nashua, NH
  • NPI 1205962396
  NPD (past) Authorized official

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1326216680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 NORTHEASTERN BLVD",
            "address_2": "SUITE 6",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03062",
            "telephone_number": "603-880-5002",
            "fax_number": "603-880-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 NORTHEASTERN BLVD",
            "address_2": "SUITE 6",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03062",
            "telephone_number": "603-880-5002",
            "fax_number": "603-880-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN PEDIATRIC DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEASTERN PEDIATRIC DENTAL",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "KALALI",
        "authorized_official_first_name": "MINA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DMD OWNER",
        "authorized_official_telephone_number": "603-880-5002",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NH",
            "license": "3374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30303168",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North American Partners in Anesthesia New Hampshire LLP
• North Light Counseling, LLC
• Northeast Family Dental Center PC
• Northeast Medical Infusion Center LLC
• Northeast Orthopaedic Alliance PLLC
• Northeastern Surgical Specialists
• Northridge Surgical Suites, LLC
• Samira Nouri, RPH
• Amy Ellen Nourie, MSW INTERN
• Novamed Surgery Center of Nashua, LLC

• Pediatric Dentistry in Nashua, NH
• Providers in Nashua, NH by specialty
• Pediatric Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.