Dr Dental of Beachmont, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR DENTAL OF BEACHMONT, PC

Practice address

38 Furlong Dr
Revere, MA 02151-4006

Phone

(508) 620-4563

NPI assigned

Dec 22, 2019

Organization subpart

No

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

Authorized official

Name

Sheila Champagne

Title

Acct Manager

Phone

(508) 620-4563

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1576972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576972800000",
    "number": "1447899406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 CONCORD ST STE 230",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017014613",
            "telephone_number": "508-620-4563",
            "fax_number": "508-297-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 FURLONG DR",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021514006",
            "telephone_number": "508-620-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DENTAL OF BEACHMONT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-22",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A",
        "authorized_official_last_name": "CHAMPAGNE",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "ACCT MANAGER",
        "authorized_official_telephone_number": "508-620-4563"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Eugene Dipietro, D.M.D.
• Ha-CHI Thi DO, PHARM.D
• Sharon Marie Dombeck, LICSW
• Nathan George Dore, A.T.C.
• Leslie S Doyle
• Dr Kuldip Vaid MD PC
• Dr Kuldip Vaid MD PC
• Dr. Fardad Mobed, P.C. (Northgate Dental Center)
• Dr.Dental of Revere, P.C.
• Marie Eehevarria, RN/BSN

• Dental Clinic/Center in Revere, MA
• Providers in Revere, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2019; 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.