NPIMap

Organization Active NPI

Beacon Family Dental

  • Dentist
  • Brookline, MA
National Provider Identifier
1588055925
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855149 Issued in MA
Legal business name
BEACON FAMILY DENTAL
Practice address
1691 Beacon St
Suite 104
Brookline, MA 02445-4400
Phone
(617) 738-6188
Fax
(857) 284-8828
NPI assigned
Feb 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

Name
Dr. Xinyan Lucy Liu, DMD
Title
Owner/Manager
Phone
(617) 738-6188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN1855149 MA Primary

Addresses

Primary practice location

1691 Beacon St
Suite 104
Brookline, MA 02445-4400

Mailing address

1691 Beacon St
Suite 104
Brookline, MA 02445-4400
Phone (617) 738-6188

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1588055925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 BEACON ST",
            "address_2": "SUITE 104",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454400",
            "telephone_number": "617-738-6188",
            "fax_number": "857-284-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 BEACON ST",
            "address_2": "SUITE 104",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454400",
            "telephone_number": "617-738-6188",
            "fax_number": "857-284-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "XINYAN",
        "authorized_official_middle_name": "LUCY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "617-738-6188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.