NPIMap

Organization Active NPI

Maynard Dental Associates, LLC

  • Dental Clinic/Center
  • Maynard, MA
National Provider Identifier
1811273378
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN1855167 Issued in MA
Legal business name
MAYNARD DENTAL ASSOCIATES, LLC
Practice address
63 Great Rd
Suite 105
Maynard, MA 01754-2097
Phone
(978) 298-5281
Fax
(978) 298-5364
NPI assigned
Oct 28, 2011
Last updated
Oct 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Dr. Alexander J Moheban, DMD
Title
Owner
Phone
(978) 298-5281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN1855167 MA Primary

Addresses

Primary practice location

63 Great Rd
Suite 105
Maynard, MA 01754-2097

Mailing address

63 Great Rd
Suite 105
Maynard, MA 01754-2097
Phone (978) 298-5281

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1811273378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 GREAT RD",
            "address_2": "SUITE 105",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542097",
            "telephone_number": "978-298-5281",
            "fax_number": "978-298-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 GREAT RD",
            "address_2": "SUITE 105",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542097",
            "telephone_number": "978-298-5281",
            "fax_number": "978-298-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYNARD DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "MOHEBAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-298-5281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "DN1855167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynard, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.