Beverly Dentistry and Braces PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BEVERLY DENTISTRY AND BRACES PC

Practice address

55 Dodge St Ste a-190
Beverly, MA 01915-1705

Phone

(508) 872-3072

Fax

(508) 872-0781

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Joanne Tavano

Title

Cfo

Phone

(978) 580-1524

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1407446941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MOUNT ROYAL AVE STE 300",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521900",
            "telephone_number": "508-872-3072",
            "fax_number": "508-872-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DODGE ST STE A-190",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151705",
            "telephone_number": "508-872-3072",
            "fax_number": "508-872-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY DENTISTRY AND BRACES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "TAVANO",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "978-580-1524",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110078301A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Constance Bertozzi, PA-C
• Beth Israel Lahey Health Primary Care, Inc.
• Samantha B Beuchert
• Beverly Dental Care PC
• Beverly Dental Group LLC
• Beverly Family Chiropractic, P.C.
• Beverly Farms Dental PLLC
• Beverly Health Department Dental Clinic
• Beverly Hospital
• Beverly Hospital

• General Practice Dentistry in Beverly, MA
• Providers in Beverly, 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 Jan 19, 2021; 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.