NPIMap

Organization Active NPI

Nelson Pan DDS Debra Hong Pan DMD Ms LLC

  • General Practice Dentistry
  • Melrose, MA
National Provider Identifier
1508943572
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16133 Issued in MA
Legal business name
NELSON PAN DDS DEBRA HONG PAN DMD MS LLC
Practice address
985 Main St
Melrose, MA 02176-1913
Phone
(781) 665-5190
Fax
(781) 979-0682
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nelson Pan, DDSNPI 1598925703
Title
Manager
Phone
(781) 665-5190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16133 MA Primary

Addresses

Primary practice location

985 Main St
Melrose, MA 02176-1913

Mailing address

985 Main St
Melrose, MA 02176-1913
Phone (781) 665-5190

Other identifiers 2

IdentifierTypeStateIssuer
86256OtherMAUNITED CONCORDIA
XO5663OtherMABCBS

Other names 1

  • Nelson Pan DDS Debra Hong Pan DMD Doing business as

National Provider Directory

National Provider Directory

Locations

985 Main St
Melrose, MA 02176
Phone (781) 665-5190

Practitioners & affiliated clinicians

Practitioners 5

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508943572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021761913",
            "telephone_number": "781-665-5190",
            "fax_number": "781-979-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021761913",
            "telephone_number": "781-665-5190",
            "fax_number": "781-979-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON PAN DDS DEBRA HONG PAN DMD MS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "NELSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "781-665-5190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "86256",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "XO5663",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nelson Pan DDS Debra Hong Pan DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.