Weston Pediatric Dental PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

20782 Issued in MA

Legal business name

WESTON PEDIATRIC DENTAL PC

Practice address

450 Boston Post Rd
Weston, MA 02493-1529

Phone

(781) 893-3003

NPI assigned

Sep 16, 2010

Last updated

Sep 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Reem Antun Lago, DMD

Title

Dentist/Owner

Phone

(781) 893-3003

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1790093490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BOSTON POST RD",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931529",
            "telephone_number": "781-893-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BOSTON POST RD",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931529",
            "telephone_number": "781-893-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON PEDIATRIC DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "ANTUN LAGO",
        "authorized_official_first_name": "REEM",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "781-893-3003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "18840",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "20782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weaver Clinic
• Weston Endodontics, LLC
• Weston Ma SNF Management, LLC
• Weston Optometric Associates PC
• Weston Orthodontic Associates, Inc.
• Weston Pediatric Physicians, P.C.
• Weston Primary Care, PC
• Ted Conrad Wetterau III
• Karisa Rana White, DNP, RN
• Richard Wiggill, LICSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.