Pediatric Dental Professionals LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN-1855617 Issued in MA

Legal business name

PEDIATRIC DENTAL PROFESSIONALS LLC

Practice address

391 Lynn Way
BLDG a
Lynn, MA 01901

Phone

(617) 393-5437

NPI assigned

Dec 17, 2015

Organization subpart

No

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

Authorized official

Name

Pedram Javedan, DDS, FAAPD

Title

Dentist

Phone

(617) 393-5437

Specialties & licenses 1

Addresses

Other names 1

• LYNN KIDS DENTAL Doing business as

Locations

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1730544743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST STE 201",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384627",
            "telephone_number": "617-393-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 LYNN WAY",
            "address_2": "BLDG A",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01901",
            "telephone_number": "617-393-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "JAVEDAN",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-393-5437",
        "authorized_official_credential": "DDS, FAAPD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN-1855617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LYNN KIDS DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marpha Paul
• Karina D Paulino-Santiago, RN
• Jill S Pearlman, PT
• Olga Cecilia Pearson
• Kerri Ann Pedersen, DEV. SPECIALIST
• Andrew Pelletier, DPM
• Stephanie Pelletier
• Sarah Elizabeth Pellini, MSW
• Erika Khemarika Pen
• Veronica Pena Vargas, NP

• Pediatric Dentistry in Lynn, MA
• Providers in Lynn, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.