Organization Active NPI

Dorchester Pediatric Dentistry and Orthodontics, PC

  • Pediatric Dentistry
  • Boston, MA
National Provider Identifier
1700387453
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN20698 Issued in MA
Legal business name
DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC
Practice address
1192 Blue Hill Ave Unit 1192
Boston, MA 02126-1819
Phone
(617) 501-7773
NPI assigned
Feb 27, 2018
Last updated
Feb 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Vandana Soni, DMDNPI 1922033208
Title
President
Phone
(617) 501-7773

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN20698 MA Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN21051 MA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X DN21679 MA

Addresses

Primary practice location

1192 Blue Hill Ave Unit 1192
Boston, MA 02126-1819

Mailing address

8 Brighton St Apt 3
Charlestown, MA 02129-1260

National Provider Directory

National Provider Directory

Locations

1192 Blue Hill Ave
Unit 1192
Boston, MA 02126
Phone (617) 501-7773

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": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1700387453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BRIGHTON ST APT 3",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021291260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 BLUE HILL AVE UNIT 1192",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021261819",
            "telephone_number": "617-501-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORCHESTER PEDIATRIC DENTISTRY AND ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "SONI",
        "authorized_official_first_name": "VANDANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-501-7773",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN20698",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN21051",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN21679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.