Mystic Valley Orthodontics

Key facts

NPI

1679744668

Entity type

Organization (NPI type 2)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X

License

19234 (MA)

Legal business name

MYSTIC VALLEY ORTHODONTICS

Practice address

80 High St
Suite 2
Medford, MA 02155-3872

Phone

(781) 396-9230

Fax

(781) 391-6090

NPI assigned

Mar 18, 2008

Organization subpart

No

Authorized official

Name

Dr. Joy Elizabeth Kasparian-Federico, D.M.D. NPI 1235259417

Title

NA

Phone

(781) 396-9230

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Joy Elizabeth Kasparian Federico, DMD Orthodontics and Dentofacial Orthopedics Dentistry · Medford, MA · NPI 1235259417
  NPD (past) Authorized official ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 18, 2008.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1679744668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HIGH ST",
            "address_2": "SUITE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HIGH ST",
            "address_2": "SUITE 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553872",
            "telephone_number": "781-396-9230",
            "fax_number": "781-391-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC VALLEY ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "KASPARIAN-FEDERICO",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "NA",
        "authorized_official_telephone_number": "781-396-9230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "19234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207021",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209104",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

• Mystic Cardiology Associates Inc
• Mystic Medical Group, Inc.
• Mystic Valley Chiropractic Office, P.C.
• Mystic Valley Dermatology Associates, P.C.
• Mystic Valley Medical Associates Inc.
• Mystick Women'S Health, Inc.
• Saima Nabi, PT, MS
• Olivia Nabiyiindi
• Michelle Nagly
• Chander M Nagpaul, M.D.

All providers in Medford, MA · Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts