Blue Harbor Dental PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

BLUE HARBOR DENTAL PLLC

Practice address

332 Victory Rd Ste 3a
Quincy, MA 02171

Phone

(617) 953-2289

Fax

(617) 801-8180

NPI assigned

Sep 1, 2017

Last updated

Aug 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Xiuping Wang, DMDNPI 1891224465

Title

Owner

Phone

(617) 953-2289

Specialties & licenses 2

Addresses

Locations

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.

• Xiuping Wang, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Quincy, MA
  • NPI 1891224465
  NPD Authorized official

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1700304425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 VICTORY RD STE 3A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021713120",
            "telephone_number": "617-953-2289",
            "fax_number": "617-801-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 VICTORY RD STE 3A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02171",
            "telephone_number": "617-953-2289",
            "fax_number": "617-801-8180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Lincoln St Ste 1106",
            "address_purpose": "LOCATION",
            "city": "Hingham",
            "state": "MA",
            "postal_code": "020431579",
            "country_code": "US",
            "telephone_number": "617-804-5533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE HARBOR DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "XIUPING",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-953-2289",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery Clinic/Center in Quincy, MA
• Providers in Quincy, MA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.