Somerville Pediatric Dentistry and Orthodontics

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SOMERVILLE PEDIATRIC DENTISTRY AND ORTHODONTICS

Practice address

51 Cross St
Somerville, MA 02145-3244

Phone

(617) 642-3139

NPI assigned

Nov 19, 2018

Last updated

Nov 19, 2018By 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. Moonyoung Lee, DMD

Title

President

Phone

(617) 642-3139

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1790254845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CROSS ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CROSS ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453244",
            "telephone_number": "617-642-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE PEDIATRIC DENTISTRY AND ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MOONYOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-642-3139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Somerville Homeless Coalition
• Somerville Homeless Coalition
• Somerville Mental Health
• Somerville Mental Health Association, Inc.
• Somerville Mental Health Association, Inc.
• Somerville Pediatric Dentistry PC
• Somerville-Cambridge Elder Services
• Somerville-Cambridge Elder Services Incorporated
• Somerville-Cambridge Elder Services, Inc
• Somerville-Cambridge Elder Services, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.