Convivial Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN1855922 Issued in MA

Legal business name

CONVIVIAL DENTAL PC

Practice address

1244 Boylston St Ste 205
Chestnut Hill, MA 02467-2115

Phone

(617) 818-0573

NPI assigned

Aug 11, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Athanasios Zavras, D.D.S, M.S, D.M.SCNPI 1417152810

Title

President

Phone

(617) 818-0573

Specialties & licenses 2

Addresses

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.

• Athanasios I. Zavras, DDS, MS, DRMSC

  • Pediatric Dentistry
  • New York, NY
  • NPI 1417152810
  NPD (past) Authorized official

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

{
    "created_epoch": "1376179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376179200000",
    "number": "1689007908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PINE ST",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020302426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 BOYLSTON ST STE 205",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672115",
            "telephone_number": "617-818-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVIVIAL DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-11",
        "last_updated": "2013-08-11",
        "status": "A",
        "authorized_official_last_name": "ZAVRAS",
        "authorized_official_first_name": "ATHANASIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-818-0573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, M.S, D.M.SC"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "DN1855922",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MA",
            "license": "DN1855922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Completendocrine LLC
• Noelle Connolly, LICSW
• Somatra Lynn Connolly, MSN, RN, PMHNP-BC
• Thomas Joseph Connolly, MD
• Larisa Eppich Connors, MD
• Fernanda D. Copeland, RD
• Caroline Corrigan
• Nina M Cotran, M.D.
• Michael Cowell, PT
• Crafts Medical Associates Inc.

• Dental Clinic/Center in Chestnut Hill, MA
• Providers in Chestnut Hill, 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 Aug 11, 2013; 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.