NPIMap

Organization Active NPI

Abc Pediatric Dentistry

  • Dentist
  • Peabody, MA
National Provider Identifier
1548699382
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19582 Issued in MA
Legal business name
ABC PEDIATRIC DENTISTRY
Practice address
111 Foster St
Peabody, MA 01960-8929
Phone
(617) 389-2112
NPI assigned
Nov 2, 2013
Last updated
Nov 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Chris Thach
Title
Office Manager
Phone
(617) 389-2112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19582 MA Primary

Addresses

Primary practice location

111 Foster St
Peabody, MA 01960-8929

Mailing address

111 Foster St
Peabody, MA 01960-8929
Phone (617) 389-2112

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1548699382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOSTER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019608929",
            "telephone_number": "617-389-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOSTER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019608929",
            "telephone_number": "617-389-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "THACH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "617-389-2112"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "19582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.