Peabody Dental Group, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN20980 Issued in MA

Legal business name

PEABODY DENTAL GROUP, LLC

Practice address

619 Lowell St Unit 2
Peabody, MA 01960-2316

Phone

(978) 535-3443

NPI assigned

Feb 23, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Richard Todd Miller, DMD

Title

President

Phone

(781) 562-0457

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1427559681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHAPMAN ST UNIT 201",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212040",
            "telephone_number": "781-562-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 LOWELL ST UNIT 2",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602316",
            "telephone_number": "978-535-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEABODY DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-562-0457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN20980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Murana Paul, CSCM
• Lovena Pauleus, RBT, BSW
• Pavlo Orthodontics, PC
• John Arthur Pavlo, DMD
• Jocelyn Ann Pawl, MSPT
• Peabody Dental LLC
• Peabody Dental Spa, PLLC
• Peabody Dental Specialties PLLC
• Peabody Family Chiropractic, Inc.
• Peabody Family Dental PLLC

• Dentist in Peabody, MA
• Providers in Peabody, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.