NPIMap

Organization Active NPI

Quabbin Valley Dental PC

  • Dental Clinic/Center
  • Athol, MA
National Provider Identifier
1437865896
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
QUABBIN VALLEY DENTAL PC
Practice address
546 Main St
Athol, MA 01331-1821
Phone
(978) 830-4610
NPI assigned
Jan 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Dr. Dong Kim, DMD
Title
Owner
Phone
(617) 888-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

546 Main St
Athol, MA 01331-1821

Mailing address

546 Main St
Athol, MA 01331-1821

Other names 1

  • QUABBIN VALLEY DENTAL LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

546 Main St
Athol, MA 01331
Phone (978) 830-4610

Practitioners & affiliated clinicians

Practitioners 1

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": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1437865896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 MAIN ST",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013311821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 MAIN ST",
            "city": "ATHOL",
            "state": "MA",
            "postal_code": "013311821",
            "telephone_number": "978-830-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUABBIN VALLEY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-888-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUABBIN VALLEY DENTAL LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Athol, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.