NPIMap

Organization Active NPI

Tatnuck Family Dental Care PLLC

  • Dental Clinic/Center
  • Worcester, MA
National Provider Identifier
1700500444
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TATNUCK FAMILY DENTAL CARE PLLC
Practice address
617 Mill St
Worcester, MA 01602-1775
Phone
(508) 756-0358
NPI assigned
Sep 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Dr. Chung Lee, DMDNPI 1639510258
Title
Dentist
Phone
(508) 756-0358

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

617 Mill St
Worcester, MA 01602-1775

Mailing address

617 Mill St Ste 4
Worcester, MA 01602-1775
Phone (508) 756-0358

National Provider Directory

National Provider Directory

Locations

617 Mill St
Ste 4
Worcester, MA 01602

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1700500444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 MILL ST STE 4",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016021775",
            "telephone_number": "508-756-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 MILL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016021775",
            "telephone_number": "508-756-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATNUCK FAMILY DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHUNG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "508-756-0358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.