NPIMap

Organization Active NPI

Idg Ipswich Dental PC

  • Dental Clinic/Center
  • Ipswich, MA
National Provider Identifier
1629616115
Registry record updated Dec 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
IDG IPSWICH DENTAL PC
Practice address
130 County Rd Ste D
Ipswich, MA 01938-2585
Phone
(978) 356-0602
NPI assigned
Dec 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2019

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

Authorized official

Name
Heejeong Son, DMDNPI 1770079485
Title
Dentist
Phone
(978) 356-0602

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

130 County Rd Ste D
Ipswich, MA 01938-2585

Mailing address

130 County Rd Ste D
Ipswich, MA 01938-2585
Phone (978) 356-0602

National Provider Directory

National Provider Directory

Locations

130 County Rd
Ste D
Ipswich, MA 01938
Phone (978) 356-0602

Practitioners & affiliated clinicians

Practitioners 2

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": "1576368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576368000000",
    "number": "1629616115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 COUNTY RD STE D",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382585",
            "telephone_number": "978-356-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 COUNTY RD STE D",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019382585",
            "telephone_number": "978-356-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDG IPSWICH DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-15",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A",
        "authorized_official_last_name": "SON",
        "authorized_official_first_name": "HEEJEONG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "978-356-0602",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ipswich, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.