Triangle Family Dental

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

19096 Issued in MA

Legal business name

TRIANGLE FAMILY DENTAL

Practice address

203 Triangle St
Amherst, MA 01002-2161

Phone

(413) 549-6270

Fax

(413) 549-6282

NPI assigned

Feb 15, 2008

Last updated

Feb 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marjan Z Khodadoust, DMDNPI 1073730354

Title

Owner/Dentist

Phone

(413) 549-6270

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marjan Khodadoust, DMD

  • General Practice Dentistry
  • Amherst, MA
  • NPI 1073730354
  NPD (past) Authorized official

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1639347222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 TRIANGLE ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022161",
            "telephone_number": "413-549-6270",
            "fax_number": "413-549-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 TRIANGLE ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022161",
            "telephone_number": "413-549-6270",
            "fax_number": "413-549-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIANGLE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "KHODADOUST",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "413-549-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "MA",
            "license": "19096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Town of Amherst
• Town of Amherst (Amherst Public Schools)
• Town of Amherst (Amherst Health Department)
• Town of Pelham (Pelham Public Schools)
• April Corrine Tremblay-Davis, DNP, APRN, NP-C
• Kelly Trinque
• Trustees of Tufts Univeristy
• Ruina Tu
• Luis Carlos Turriago, PHD
• Umass Health Services Amherst

• Public Health Dentistry in Amherst, MA
• Providers in Amherst, MA by specialty
• Public Health Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.