NPIMap

Organization Active NPI

Sun Dental Center

  • General Practice Dentistry
  • Worcester, MA
National Provider Identifier
1437313467
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19510 Issued in MA
Legal business name
SUN DENTAL CENTER
Practice address
484 Main St # 320
Worcester, MA 01608-1893
Phone
(617) 947-3999
NPI assigned
Jul 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
Dr. Jenny Tjahjono, DMD
Title
Dentist
Phone
(617) 947-3999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19510 MA Primary

Addresses

Primary practice location

484 Main St # 320
Worcester, MA 01608-1893

Mailing address

484 Main St # 320
Worcester, MA 01608-1893
Phone (617) 947-3999

National Provider Directory

National Provider Directory

Locations

484 Main St
Ste 320
Worcester, MA 01608
Phone (617) 947-3999

NPI Registry JSON

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1437313467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 MAIN ST # 320",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "617-947-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 MAIN ST # 320",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "617-947-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "TJAHJONO",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-947-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.