NPIMap

Organization Active NPI

Waltham Modern Dentistry, PC

Doing business as Waltham Modern Dentistry

  • Dentist
  • Waltham, MA
National Provider Identifier
1528525482
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WALTHAM MODERN DENTISTRY, PC
Doing business as
Waltham Modern Dentistry
Practice address
862 Lexington St
Waltham, MA 02452-4849
Phone
(781) 684-9714
Fax
(781) 325-1165
NPI assigned
Feb 27, 2019
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Anthony Falone, DDS
Title
Owner/DDS
Phone
(781) 684-9714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

862 Lexington St
Waltham, MA 02452-4849

Mailing address

PO Box 920050
Dallas, TX 75392-0050

Other names 1

  • Waltham Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

862 Lexington St
Waltham, MA 02452
Phone (781) 684-9714

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1528525482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 LEXINGTON ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524849",
            "telephone_number": "781-684-9714",
            "fax_number": "781-325-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTHAM MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "FALONE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "781-684-9714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waltham Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waltham Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.