NPIMap

Organization Active NPI

Apollo Dental Ass.

  • General Practice Dentistry
  • Dorchester, MA
National Provider Identifier
1700148301
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
APOLLO DENTAL ASS.
Practice address
940 Dorchester Ave
Dorchester, MA 02125-1218
Phone
(617) 354-1678
Fax
(617) 354-2927
NPI assigned
Jun 11, 2012
Last updated
Jun 11, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
APOLLO DENTAL ASSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Dr. Dieutrang Bui, DMDNPI 1437171659
Title
Owner
Phone
(617) 354-1678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

940 Dorchester Ave
Dorchester, MA 02125-1218

Mailing address

940 Dorchester Ave
Dorchester, MA 02125-1218
Phone (617) 354-1678

Other identifiers 1

IdentifierTypeStateIssuer
9703195MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Apollo Dental Ass2 organizations share this tax ID, including this one
Part of
Apollo Dental Ass

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1700148301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251218",
            "telephone_number": "617-354-1678",
            "fax_number": "617-354-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251218",
            "telephone_number": "617-354-1678",
            "fax_number": "617-354-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO DENTAL ASS.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "APOLLO DENTAL ASS",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "DIEUTRANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-354-1678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703195",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.