Lawrence Smiles Youth Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAWRENCE SMILES YOUTH DENTISTRY, LLC

Practice address

73C Winthrop Ave
Lawrence, MA 01843-3716

Phone

(978) 725-6525

Fax

(978) 725-6550

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jenell Stump

Title

Manager

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1407903750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73C WINTHROP AVE",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-725-6525",
            "fax_number": "978-725-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE SMILES YOUTH DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "STUMP",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110069905A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3079920",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence General Hospital (LGH Vaccination Clinic)
• Lawrence General Hospital (Emergency and Medical Physicians)
• Lawrence Health Solutions, LLC
• Lawrence Opco LLC (Royal Wood Mill Center)
• Lawrence Smile Design LLC
• Lazarus House, Inc.
• Toby Lazerson, MSW; LICSW
• Anne C Le, PHARMD
• Dat Tat Le, MD EFFECTIVE 6/1/12
• Pamilli Leandro Bezerra, MD

• General Practice Dentistry in Lawrence, MA
• Providers in Lawrence, 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 Jul 9, 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.