Coredental, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN1856376 Issued in MA

Legal business name

COREDENTAL, LLC

Practice address

611 Adams St
Quincy, MA 02169-1319

Phone

(617) 479-9191

Fax

(617) 481-6635

NPI assigned

Jan 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Frederick Nafash

Title

Sole Member

Phone

(617) 634-9393

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1750828752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 ADAMS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691319",
            "telephone_number": "617-651-5255",
            "fax_number": "617-481-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ADAMS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691319",
            "telephone_number": "617-479-9191",
            "fax_number": "617-481-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREDENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "NAFASH",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "617-634-9393",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1856376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kievaughna Copeland
• Marjorie Copeland
• Gabrielle Bobbi Coppola, CNM/NP
• Sheila Corcoran, M.ED.
• Varayna E Cordell, M.S.
• Susan Corey
• Lisa Brancato Corkins, MD
• Olivia Addison Corneyea
• Amanda Marie Correia, LPN
• Christina Marie Correnti, MD, MSCR

• Periodontics in Quincy, MA
• Providers in Quincy, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.