NPIMap

Organization Active NPI

Lux Dental for Kids

  • Pediatric Dentistry
  • Saugus, MA
National Provider Identifier
1417204884
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
20827 Issued in MA
Legal business name
LUX DENTAL FOR KIDS
Doing business as
LUX DENTAL FOR KIDS
Practice address
1201 Broadway
Room E215
Saugus, MA 01906-4177
Phone
(781) 558-5092
Fax
(206) 203-2845
NPI assigned
Aug 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Authorized official

Name
Dr. Abdullaibrahim AbdulwaheedNPI 1760576250
Title
President
Phone
(781) 558-5092

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
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 20827 MA Primary

Addresses

Primary practice location

1201 Broadway
Room E215
Saugus, MA 01906-4177

Mailing address

505 Washington St
Quincy, MA 02169-5834
Phone (617) 756-1928

Other names 1

  • LUX DENTAL FOR KIDS Doing business as

National Provider Directory

National Provider Directory

Locations

505 Washington St
Quincy, MA 02169
Phone (617) 639-5942

1201 Broadway
Spc E215
Saugus, MA 01906
Phone (617) 756-1928

Practitioners & affiliated clinicians

Practitioners 4

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": "1344038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1417204884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WASHINGTON ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695834",
            "telephone_number": "617-756-1928",
            "fax_number": "206-203-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROADWAY",
            "address_2": "ROOM E215",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019064177",
            "telephone_number": "781-558-5092",
            "fax_number": "206-203-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUX DENTAL FOR KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-04",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "ABDULWAHEED",
        "authorized_official_first_name": "ABDULLAIBRAHIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-558-5092",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "20827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LUX DENTAL FOR KIDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saugus, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.