NPIMap

Organization Active NPI

Seaport Dental Associates, LLC

  • General Practice Dentistry
  • Milton, MA
National Provider Identifier
1326417569
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21316 Issued in MA
Legal business name
SEAPORT DENTAL ASSOCIATES, LLC
Practice address
588 Randolph Ave
Milton, MA 02186-4524
Phone
(617) 737-6453
Fax
(617) 737-6324
NPI assigned
Sep 17, 2015
Organization subpart
Yes
Parent organization
SEAPORT DENTAL ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Dr. Elizabeth Greenberg Rooney, DMDNPI 1417073586
Title
Owner
Phone
(617) 737-6453

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 21316 MA Primary

Addresses

Primary practice location

588 Randolph Ave
Milton, MA 02186-4524

Mailing address

451 D St Ste 200
Boston, MA 02210-1964
Phone (617) 737-6453

National Provider Directory

National Provider Directory
Tax ID family
Seaport Dental Associates LLC2 organizations share this tax ID, including this one
Part of
Seaport Dental Associates LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

451 D St
Ste 200
Boston, MA 02210
Phone (617) 737-6453

588 Randolph Ave
Milton, MA 02186
Phone (617) 737-6453

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1326417569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 D ST STE 200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101964",
            "telephone_number": "617-737-6453",
            "fax_number": "617-737-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 RANDOLPH AVE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021864524",
            "telephone_number": "617-737-6453",
            "fax_number": "617-737-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAPORT DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEAPORT DENTAL ASSOCIATES, LLC",
        "enumeration_date": "2015-09-17",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "ROONEY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "GREENBERG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-737-6453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.