Waltham Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20802 Issued in MA

Legal business name

WALTHAM FAMILY DENTAL

Practice address

30 Grant St
Waltham, MA 02453-4202

Phone

(781) 894-1634

NPI assigned

May 17, 2016

Organization subpart

No

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

Authorized official

Name

Vik Kapoor

Title

Manager

Phone

(617) 953-5221

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1548617814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GRANT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GRANT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024534202",
            "telephone_number": "781-894-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTHAM FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "KAPOOR",
        "authorized_official_first_name": "VIK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-953-5221"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN20802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waltham Dental Group
• Waltham Diabetes Center, LLC
• Waltham Dialysis LLC (The Dialysis Center at Waltham)
• Waltham Drug LLC (Watch City Pharmacy)
• Waltham Drug LLC (Watch City Pharmacy)
• Waltham Family Practice, PC
• Waltham Modern Dentistry, PC (Waltham Modern Dentistry)
• Waltham Weston Internal Medicine Associates, P.C.
• CHI Shiang Wang, MD
• Katherine J Wangh, LICSW

• General Practice Dentistry in Waltham, MA
• Providers in Waltham, 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 May 17, 2016; 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.