Mary Qian, D.M.D.
Individual provider Active NPI Dentist · Quincy, MA
NPI 1487961801 · NPPES record last updated Feb 25, 2011
Key facts
- NPI
- 1487961801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN1855619 (MA)
- Practice address
- 505 Washington St
Quincy, MA 02169-5834 - Phone
- (617) 639-5942
- Fax
- (617) 639-5596
- NPI assigned
- Sep 7, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855619 | MA | MD | Dentist |
| DI02453900 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lux Dental | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1855619 | MA | Yes |
| General Practice Dentistry | 1223G0001X | DI02453900 | NJ |
Addresses
Primary practice location
505 Washington St
Quincy, MA 02169-5834
Mailing address
505 Washington St
Quincy, MA 02169-5834
Phone (617) 639-5942
Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.