NPIMap

Organization Active NPI

Lakeville Dental Associates, P.C.

  • Dental Clinic/Center
  • Lakeville, MA
National Provider Identifier
1710156930
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
20826 Issued in MA
Legal business name
LAKEVILLE DENTAL ASSOCIATES, P.C.
Practice address
54 Main St
Suite 6
Lakeville, MA 02347-3621
Phone
(508) 923-6900
Fax
(508) 946-0306
NPI assigned
Feb 21, 2008
Last updated
Feb 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Dr. Chuong Pham, D.M.D.NPI 1962569475
Title
Dentist
Phone
(508) 923-6900

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
Dental Clinic/Center 261QD0000X 20826 MA Primary

Addresses

Primary practice location

54 Main St
Suite 6
Lakeville, MA 02347-3621

Mailing address

54 Main St
Suite 6
Lakeville, MA 02347-3621
Phone (508) 923-6900

Other identifiers 2

IdentifierTypeStateIssuer
1811540OtherMAUNITED CONCORDIA
X12180OtherMABCBS OF MA

Other names 1

  • Lakeville Dental Associates, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

54 Main St
Ste 6
Lakeville, MA 02347
Phone (508) 923-6900

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": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1710156930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MAIN ST",
            "address_2": "SUITE 6",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023473621",
            "telephone_number": "508-923-6900",
            "fax_number": "508-946-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MAIN ST",
            "address_2": "SUITE 6",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023473621",
            "telephone_number": "508-923-6900",
            "fax_number": "508-946-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "CHUONG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "508-923-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "20826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1811540",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "X12180",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeville Dental Associates, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lakeville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.