NPIMap

Organization Active NPI

Dental Care of Wilmington, LLC

  • Dentist
  • Wilmington, MA
National Provider Identifier
1780828434
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21908 Issued in MA
Legal business name
DENTAL CARE OF WILMINGTON, LLC
Practice address
66 Unit T Concord St
Wilmington, MA 01887
Phone
(978) 694-1090
NPI assigned
Apr 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Authorized official

Name
Yan LuNPI 1851590384
Title
President
Phone
(617) 851-9585

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: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 21908 MA Primary

Addresses

Primary practice location

66 Unit T Concord St
Wilmington, MA 01887

Mailing address

PO Box 4126
Andover, MA 01810-0812

National Provider Directory

National Provider Directory

Locations

66 Concord St
#T
Wilmington, MA 01887
Phone (978) 694-1090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1780828434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4126",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018100812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 UNIT T CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-694-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE OF WILMINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-25",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-851-9585"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "21908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.