Medford Endodontics, LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

20514 Issued in MA

Legal business name

MEDFORD ENDODONTICS, LLC

Practice address

Zero Governors Avenue, Suite 30
Medford, MA 02155-3006

Phone

(781) 391-5100

Fax

(781) 391-4833

NPI assigned

Apr 14, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark G Wang, D.M.D.

Title

President

Phone

(781) 391-5100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1780974477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ZERO GOVERNORS AVENUE., SUITE 30",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021550000",
            "telephone_number": "781-391-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ZERO GOVERNORS AVENUE, SUITE 30",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553006",
            "telephone_number": "781-391-5100",
            "fax_number": "781-391-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD ENDODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-391-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "20514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medford Adhc
• Medford Armory Dental P.C.
• Medford Clinical Laboratories
• Medford Dental Associates, LLC
• Medford Dental Wellness Center, PC
• Medford Eyecare LLC
• Medford Eyeglass Shop Inc.
• Medford Family & Cosmetic Dentistry PLLC
• Medford Family Dental Care
• Medford Healthcare Group, LLC

• Endodontics in Medford, MA
• Providers in Medford, MA by specialty
• Endodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.