Organization Active NPI

Burlington Childrens Dental

  • Pediatric Dentistry
  • Burlington, MA
National Provider Identifier
1669687166
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BURLINGTON CHILDRENS DENTAL
Practice address
131 Cambridge St Ste 1
Burlington, MA 01803-3711
Phone
(781) 229-2220
Fax
(781) 229-0258
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Dr. Morteza Yazdi, D.M.DNPI 1477563682
Title
Dentist
Phone
(781) 229-2220

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: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

131 Cambridge St Ste 1
Burlington, MA 01803-3711

Mailing address

30 Chesnut Ave
Suite 1
Burlington, MA 01803-1607
Phone (781) 229-2220

Other identifiers 2

IdentifierTypeStateIssuer
0297828OtherMAMASS HEALTH
110011979BMedicaidMA

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": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1669687166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CHESNUT AVE",
            "address_2": "SUITE 1",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018031607",
            "telephone_number": "781-229-2220",
            "fax_number": "781-229-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CAMBRIDGE ST STE 1",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033711",
            "telephone_number": "781-229-2220",
            "fax_number": "781-229-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON CHILDRENS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "YAZDI",
        "authorized_official_first_name": "MORTEZA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-229-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "0297828",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110011979B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.