Idg Danvers Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

IDG DANVERS DENTAL PC

Practice address

7 Federal St Ste 25
Danvers, MA 01923-3620

Phone

(978) 739-4100

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Heeju Son

Title

Director

Phone

(857) 262-5308

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1376290189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FEDERAL ST STE 25",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FEDERAL ST STE 25",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233620",
            "telephone_number": "978-739-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDG DANVERS DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "SON",
        "authorized_official_first_name": "HEEJU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "857-262-5308"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Hyde-Bradford
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• Bridgette Ingemi
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• Albert J Intonti, DMD

• Dental Clinic/Center in Danvers, MA
• Providers in Danvers, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.