Life Bridge Dental Ma PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LIFE BRIDGE DENTAL MA PLLC

Doing business as

Tend Dental

Practice address

12 Post Office SQ
Boston, MA 02109-3924

Phone

(212) 686-3686

Fax

(615) 468-0325

NPI assigned

Aug 24, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth N Sullivan

Title

Director, RCM

Phone

(615) 601-5250

Specialties & licenses 1

Addresses

Other names 1

• Tend Dental Doing business as

Locations

Practitioners 2

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.

• Keron Kamali Williams

  • Dental Assistant
  • Boston, MA
  • NPI 1568144624
  NPD
• Taym Almetwali, DMD

  • Dentist
  • Lebanon, NH
  • NPI 1104591502

  General Practice

  NPD

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1730856196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT CH 17135",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600557135",
            "telephone_number": "212-686-3686",
            "fax_number": "615-468-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 POST OFFICE SQ",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093924",
            "telephone_number": "212-686-3686",
            "fax_number": "615-468-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BRIDGE DENTAL MA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR, RCM",
        "authorized_official_telephone_number": "615-601-5250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tend Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary L Lievens, NP
• Jean W Liew, MD
• Sabrina Qui Rong Liew, MD
• Wendy Kein Meng Liew, M.D.
• Life Balancing Acts
• Chelsea Skye Life
• Ingrid Liff, MD
• Karen Loeb Lifford, M.D.
• Nicole R Lifson, MD
• Light House Behavioral Health and Wellness Center Inc.

• General Practice Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.