NPIMap

Organization Active NPI

Beacon Dental Health PC

Doing business as Wollaston Dental Group

  • Dental Clinic/Center
  • Wollaston, MA
National Provider Identifier
1376186528
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BEACON DENTAL HEALTH PC
Doing business as
Wollaston Dental Group
Practice address
628 Hancock St
Wollaston, MA 02170-2004
Phone
(617) 418-6940
NPI assigned
Oct 21, 2019
Last updated
Oct 21, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BEACON DENTAL HEALTH PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Rishi Shukla
Title
Authorized Administrator
Phone
(617) 418-6940

Specialties & licenses 1

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

Addresses

Primary practice location

628 Hancock St
Wollaston, MA 02170-2004

Mailing address

198 Tremont St Ste 436
Boston, MA 02116-4705
Phone (617) 418-6940

Other names 1

  • Wollaston Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beacon Dental Health PC13 organizations share this tax ID, including this one
Part of
Beacon Dental Health PC

Other organizations with this tax ID 12

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

Locations

198 Tremont St
Boston, MA 02116
Phone (203) 910-4904

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.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1376186528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 TREMONT ST STE 436",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164705",
            "telephone_number": "617-418-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HANCOCK ST",
            "city": "WOLLASTON",
            "state": "MA",
            "postal_code": "021702004",
            "telephone_number": "617-418-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON DENTAL HEALTH PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON DENTAL HEALTH PC",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "SHUKLA",
        "authorized_official_first_name": "RISHI",
        "authorized_official_title_or_position": "AUTHORIZED ADMINISTRATOR",
        "authorized_official_telephone_number": "617-418-6940"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wollaston Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wollaston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.