NPIMap

Organization Active NPI

Cambridge Children'S Dentistry PC

  • Pediatric Dentistry
  • Cambridge, MA
National Provider Identifier
1578823902
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN1855617 Issued in MA
Legal business name
CAMBRIDGE CHILDREN'S DENTISTRY PC
Practice address
575 Mount Auburn St
Suite 201
Cambridge, MA 02138-4656
Phone
(617) 383-4356
NPI assigned
May 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Pedram Javedan, DDSNPI 1821295452
Title
President
Phone
(617) 383-4356

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DN1855617 MA Primary

Addresses

Primary practice location

575 Mount Auburn St
Suite 201
Cambridge, MA 02138-4656

Mailing address

575 Mount Auburn St
Suite 201
Cambridge, MA 02138-4656

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1578823902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST",
            "address_2": "SUITE 201",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST",
            "address_2": "SUITE 201",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384656",
            "telephone_number": "617-383-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE CHILDREN'S DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "JAVEDAN",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-383-4356",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1855617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.