NPIMap

Organization Active NPI

Grace Family Dental LLC

  • Dentist
  • Worcester, MA
National Provider Identifier
1811224686
Registry record updated Nov 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21183 Issued in MA
Legal business name
GRACE FAMILY DENTAL LLC
Practice address
16 Park Ave
Worcester, MA 01605-3911
Phone
(508) 425-7180
NPI assigned
Nov 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2009

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

Authorized official

Name
Dr. Harjeet Mundra, DMDNPI 1770631087
Title
Owner
Phone
(508) 425-7180

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 SINGLE SPECIALTY GROUP 122300000X 21183 MA Primary

Addresses

Primary practice location

16 Park Ave
Worcester, MA 01605-3911

Mailing address

16 Park Ave
Worcester, MA 01605-3911

National Provider Directory

National Provider Directory

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": "1258243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258243200000",
    "number": "1811224686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053911",
            "telephone_number": "508-425-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-15",
        "last_updated": "2009-11-15",
        "status": "A",
        "authorized_official_last_name": "MUNDRA",
        "authorized_official_first_name": "HARJEET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-425-7180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "21183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2009; 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.