Central Square Family Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20485 Issued in MA

Legal business name

CENTRAL SQUARE FAMILY DENTAL PC

Practice address

714 Massachusetts Ave
Cambridge, MA 02139-3308

Phone

(617) 868-9400

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Julia Faigel, DMD

Title

President

Phone

(617) 868-9400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Palwasha Jan Durrani, DMD

  • Dentist
  • Cambridge, MA
  • NPI 1861901233
  NPD (past)
• Shyamala Nagendran Naidu

  • General Practice Dentistry
  • Boston, MA
  • NPI 1811793722
  NPD (past)
• Olga L Povolotskaia, DDS

  • Dentist
  • Cambridge, MA
  • NPI 1699968388
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407907249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393308",
            "telephone_number": "617-868-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393308",
            "telephone_number": "617-868-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SQUARE FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAIGEL",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-868-9400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203980",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center for Family Connection
• Center for Human Genetics, Inc
• Rosemary Centola, LMT
• Anthony Joseph Centore, PH.D.
• Central Square Dental PC
• Central Square Mental Health, LLC
• Anthony James Cerami
• Jazlyn M Cerbin, LCSW
• Nicole Cesanek
• Ecesu Cetin

• General Practice Dentistry in Cambridge, MA
• Providers in Cambridge, 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 Aug 22, 2020; 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.