NPIMap

Organization Active NPI

42 North Dental Oral Surgery of Ma, PLLC

Doing business as South Shore Oral Surgery Associates

  • Dental Clinic/Center
  • Quincy, MA
National Provider Identifier
1730846403
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL ORAL SURGERY OF MA, PLLC
Doing business as
South Shore Oral Surgery Associates
Practice address
270 Quincy Ave
Quincy, MA 02169-8127
Phone
(617) 773-9500
NPI assigned
Nov 17, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
42 NORTH DENTAL ORAL SURGERY OF MA, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Authorized official

Name
Michael Angelo Scialabba
Title
Cheif Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

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

Addresses

Primary practice location

270 Quincy Ave
Quincy, MA 02169-8127

Mailing address

270 Quincy Ave
Quincy, MA 02169-8127
Phone (617) 773-9500

Other names 1

  • South Shore Oral Surgery Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Oral Surgery of Ma PLLC2 organizations share this tax ID, including this one
Part of
42 North Dental Oral Surgery of Ma PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

270 Quincy Ave
Quincy, MA 02169
Phone (617) 773-9500

Practitioners & affiliated clinicians

Practitioners 5

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": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1730846403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698127",
            "telephone_number": "617-773-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698127",
            "telephone_number": "617-773-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "42 NORTH DENTAL ORAL SURGERY OF MA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL ORAL SURGERY OF MA, PLLC",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANGELO",
        "authorized_official_title_or_position": "CHEIF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Shore Oral Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.