Back Bay Boston Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BACK BAY BOSTON DENTAL LLC

Practice address

745 Boylston St
Boston, MA 02116-2636

Phone

(646) 644-7394

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Panagiotis Papaspyridakos, DDS

Title

Owner

Phone

(646) 644-7394

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1356065684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SAINT GERMAIN ST APT 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021153248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 BOYLSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162636",
            "telephone_number": "646-644-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK BAY BOSTON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "PAPASPYRIDAKOS",
        "authorized_official_first_name": "PANAGIOTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-644-7394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Bachorik, M.D.
• Salam Bachour
• Nathaniel Dale Bachtel, MD, PHD
• Richard G Bachur, MD
• Back and Balance Rehabilitation Center
• Back Bay Cognitive Behavioral Therapy LLC
• Back Bay Dental Group LLC
• Back Bay Health LLC
• Back Bay Home Health Care, LLC
• Back Bay Mental Health LLC

• General Practice Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.