NPIMap

Organization Active NPI

Clean and Seal Dental Program

  • Public Health or Welfare Agency
  • Dorchester, MA
National Provider Identifier
1821601170
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CLEAN AND SEAL DENTAL PROGRAM
Practice address
172 Ashmont St
Dorchester, MA 02124-3745
Phone
(774) 321-4720
NPI assigned
Aug 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Authorized official

Name
Faith Brooks, RDH, BSDH, M.EDNPI 1760095012
Title
Public Health Dental Hygienist
Phone
(774) 321-4720

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
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

172 Ashmont St
Dorchester, MA 02124-3745

Mailing address

172 Ashmont St
Dorchester, MA 02124-3745
Phone (774) 321-4720

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": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1821601170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 ASHMONT ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243745",
            "telephone_number": "774-321-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 ASHMONT ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243745",
            "telephone_number": "774-321-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN AND SEAL DENTAL PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "PUBLIC HEALTH DENTAL HYGIENIST",
        "authorized_official_telephone_number": "774-321-4720",
        "authorized_official_credential": "RDH, BSDH, M.ED"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.