Somerville Pediatric Dentistry PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SOMERVILLE PEDIATRIC DENTISTRY PC

Practice address

51 Cross St
Somerville, MA 02145-3244

Phone

(617) 227-2421

NPI assigned

Oct 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Lee W Thach, DMD

Title

Pediatric Dentist

Phone

(617) 227-2421

Specialties & licenses 1

Addresses

Other names 1

• Somerville Pediatric Dentistry PC Doing business as

Locations

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1740061613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EVERETT AVE STE 10",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502374",
            "telephone_number": "617-389-2112",
            "fax_number": "617-389-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CROSS ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453244",
            "telephone_number": "617-227-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE PEDIATRIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-07",
        "status": "A",
        "authorized_official_last_name": "THACH",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "617-227-2421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerville Pediatric Dentistry PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Somerville Homeless Coalition
• Somerville Mental Health
• Somerville Mental Health Association, Inc.
• Somerville Mental Health Association, Inc.
• Somerville Pediatric Dentistry and Orthodontics
• Somerville-Cambridge Elder Services
• Somerville-Cambridge Elder Services Incorporated
• Somerville-Cambridge Elder Services, Inc
• Somerville-Cambridge Elder Services, Inc
• Tamara Tereza Soraluz

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.