NPIMap

Organization Active NPI

Dental Associates Randolph

  • Dentist
  • Randolph, MA
National Provider Identifier
1629520887
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18174 Issued in MA
Legal business name
DENTAL ASSOCIATES RANDOLPH
Practice address
56 S Main Street
Randolph, MA 02368-4861
Phone
(617) 323-3443
NPI assigned
Nov 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Authorized official

Name
Ramesh Izedian, DMD
Title
Dentist
Phone
(617) 953-9647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18174 MA Primary

Addresses

Primary practice location

56 S Main Street
Randolph, MA 02368-4861

Mailing address

673 Robeson Street
Fall River, MA 02720
Phone (508) 676-8268

Other names 1

  • Dental Associates Randolph Other name

National Provider Directory

National Provider Directory

Locations

56 S Main St
Randolph, MA 02368
Phone (781) 963-0860

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1629520887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 ROBESON STREET",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-676-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 S MAIN STREET",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684861",
            "telephone_number": "617-323-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES RANDOLPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "IZEDIAN",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-953-9647",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "18174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Associates Randolph",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.