Ace Dental West Roxbury, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ACE DENTAL WEST ROXBURY, PLLC

Practice address

1840 Centre St
West Roxbury, MA 02132-1901

Phone

(617) 327-5700

NPI assigned

Jan 26, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Shawn Kim, DDSNPI 1316227499

Title

Manager

Phone

(617) 361-5020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Seonghoon Kim, D.D.S.

  • General Practice Dentistry
  • Hyde Park, MA
  • NPI 1316227499
  NPD Authorized official
• Ryan Park, DMD

  • General Practice Dentistry
  • Hyde Park, MA
  • NPI 1588235196
  NPD (past)
• Inara E. Zalitis, DDS

  • Pediatric Dentistry
  • West Roxbury, MA
  • NPI 1942279468
  NPD (past)

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1679225114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 RIVER ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362970",
            "telephone_number": "617-361-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321901",
            "telephone_number": "617-327-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE DENTAL WEST ROXBURY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-361-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "DN1856147",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 5060 Washington Street Operating Company, LLC (Care Village at West Roxbury)
• A Beautiful Smile Dentistry LLC
• Kobina Abban-Saah, RN
• Nicolas Abbott
• Carol Abizaid, LICSW
• Andrea Acosta, PA-C
• Michael Arthur Adams, RN
• Advanced Dental Sleep Medicine of Connecticut, PC
• Sumaiya Afroz
• Elsa J Aguilera, M.D.

• Dental Clinic/Center in West Roxbury, MA
• Providers in West Roxbury, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.