Organization Active NPI

Au Blanc PLLC

  • Dentist
  • Wellesley, MA
National Provider Identifier
1770177875
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AU BLANC PLLC
Practice address
1 Hollis St Ste 140
Wellesley, MA 02482-4690
Phone
(781) 235-6616
NPI assigned
Mar 1, 2021
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Dr. Tarek P Shaib, DMDNPI 1215397872
Title
Owner Dentist
Phone
(781) 235-6616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1 Hollis St Ste 140
Wellesley, MA 02482-4690

Mailing address

1 Hollis St Ste 140
Wellesley, MA 02482-4690
Phone (781) 235-6616

National Provider Directory

National Provider Directory

Locations

1 Hollis St
Ste 140
Wellesley, MA 02482
Phone (781) 235-6616

Practitioners & affiliated clinicians

Practitioners 1

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": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1770177875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLIS ST STE 140",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024824690",
            "telephone_number": "781-235-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOLLIS ST STE 140",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024824690",
            "telephone_number": "781-235-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AU BLANC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "SHAIB",
        "authorized_official_first_name": "TAREK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "781-235-6616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.