Cambridge Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

CAMBRIDGE PERIODONTICS

Practice address

1692 Massachusetts Avenue
Cambridge, MA 02138

Phone

(617) 864-5444

Fax

(617) 547-0109

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark C DerkazarianNPI 1841331097

Title

Partner

Phone

(617) 864-5444

Specialties & licenses 1

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.

• Mark Charles Derkazarian, D.M.D.

  • Periodontics
  • Cambridge, MA
  • NPI 1841331097
  Authorized official Same address or phone

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1700896164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 MASSACHUSETTS AVENUE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-864-5444",
            "fax_number": "617-547-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 MASSACHUSETTS AVENUE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-864-5444",
            "fax_number": "617-547-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "DERKAZARIAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-864-5444",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cambridge Neurosurgical Spinecare LLC
• Cambridge Oral Surgery PC
• Cambridge Orthodontics
• Cambridge Otolaryngology
• Cambridge Pediatric Dental Associates, P.C.
• Cambridge Periodontics LLC
• Cambridge Physical Therapy and Sports Medicine
• Cambridge Physical Therapy, Inc.
• Cambridge Psychiatric Services, Inc
• Cambridge Psychiatry LLC

• Periodontics in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.