NPIMap

Organization Active NPI

Jurgina Elezi DMD LLC

  • Dental Clinic/Center
  • Revere, MA
National Provider Identifier
1386053155
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN21646 Issued in MA
Legal business name
JURGINA ELEZI DMD LLC
Practice address
7 Foster St Ste 1
Revere, MA 02151-3419
Phone
(781) 284-4100
NPI assigned
Aug 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Dr. Jurgina Elezi, DMDNPI 1982758777
Title
Owner
Phone
(781) 284-4100

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
Dental Clinic/Center 261QD0000X DN21646 MA Primary

Addresses

Primary practice location

7 Foster St Ste 1
Revere, MA 02151-3419

Mailing address

7 Foster St Ste 1
Revere, MA 02151-3419
Phone (781) 284-4100

Other names 1

  • Revere Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coddington Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7 Foster St
Ste 1
Revere, MA 02151
Phone (781) 284-4100

Practitioners & affiliated clinicians

Practitioners 1

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": "1407283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1386053155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FOSTER ST STE 1",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513419",
            "telephone_number": "781-284-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FOSTER ST STE 1",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513419",
            "telephone_number": "781-284-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JURGINA ELEZI DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "ELEZI",
        "authorized_official_first_name": "JURGINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-284-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "DN21646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revere Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.