Great Road Dental Associates,P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19336 Issued in MA

Legal business name

GREAT ROAD DENTAL ASSOCIATES,P.C

Practice address

296 Great Rd
Acton, MA 01720-4710

Phone

(978) 263-8525

Fax

(978) 263-2955

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kinan Kanbar

Title

President

Phone

(978) 263-8525

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548320179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204710",
            "telephone_number": "978-263-8525",
            "fax_number": "978-263-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204710",
            "telephone_number": "978-263-8525",
            "fax_number": "978-263-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT ROAD DENTAL ASSOCIATES,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANBAR",
        "authorized_official_first_name": "KINAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-263-8525",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna M Goodwill, M.S.W., L.I.C.S.W.
• Ingrid Gorman, M.D.
• Alison N Gould, MA
• Shannon Marie Granger
• Great Road Acupuncture and Herbs LLC
• Greene Nutrition, LLC
• William Gresser, M.A.
• Zachary Gresser, LMHC
• Stephen H Grossman, DMD
• Jillian Guarino

• General Practice Dentistry in Acton, MA
• Providers in Acton, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.