NPIMap

Organization Active NPI

Pediatric Dental Group Inc

  • Pediatric Dentistry
  • Marlborough, MA
National Provider Identifier
1669767117
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12581 Issued in MA
Legal business name
PEDIATRIC DENTAL GROUP INC
Practice address
116 Main St
Suite1
Marlborough, MA 01752-3811
Phone
(508) 485-2001
Fax
(508) 485-2201
NPI assigned
Jun 13, 2011
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Todd Pachello
Title
President Chief Revenue Officer
Phone
(720) 475-6482

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 12581 MA Primary

Addresses

Primary practice location

116 Main St
Suite1
Marlborough, MA 01752-3811

Mailing address

116 Main St
Suite1
Marlborough, MA 01752-3811
Phone (508) 485-2001

National Provider Directory

National Provider Directory
Tax ID family
The Pediatric Dental Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1669767117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "address_2": "SUITE1",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523811",
            "telephone_number": "508-485-2001",
            "fax_number": "508-485-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "address_2": "SUITE1",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523811",
            "telephone_number": "508-485-2001",
            "fax_number": "508-485-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "PACHELLO",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "720-475-6482"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "12581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.