Peachy Smiles Ashmont LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19161 Issued in MA

Legal business name

PEACHY SMILES ASHMONT LLC

Practice address

172 Ashmont St
Dorchester Center, MA 02124-3745

Phone

(617) 288-2920

Fax

(617) 288-2992

NPI assigned

Aug 11, 2008

Last updated

Aug 11, 2008By 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. Peach B Dore-Tyrell, DMDNPI 1497968952

Title

Dentist

Phone

(617) 288-2920

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peach B Dore-Tyrell, DMD

  • General Practice Dentistry
  • Dorchester, MA
  • NPI 1497968952
  Authorized official Same address or phone

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1831345834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 ASHMONT ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243745",
            "telephone_number": "617-288-2920",
            "fax_number": "617-288-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 ASHMONT ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243745",
            "telephone_number": "617-288-2920",
            "fax_number": "617-288-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHY SMILES ASHMONT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "DORE-TYRELL",
        "authorized_official_first_name": "PEACH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-288-2920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "0280771",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nissage Cadet, MD PC
• Rita N Okafor, LPN
• Anthony Bernard Oliva, D.M.D
• Ashok Jivanlal Patel, M.D.
• Paul E. Boinay M.D., P.C.
• Robert R. Perry Jr., DMD
• Siobhan Peters
• Marie Andree Pierre-Victor, MSW, LICSW
• Martin Randy Pierre, PH.D.
• Pine Street Inn, Inc.

• General Practice Dentistry in Dorchester Center, MA
• Providers in Dorchester Center, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.