NPIMap

Organization Active NPI

Clarke Street Family Dental LLC

  • Dentist
  • Lexington, MA
National Provider Identifier
1841591740
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18996 Issued in MA
Legal business name
CLARKE STREET FAMILY DENTAL LLC
Practice address
16 Clarke St
Lexington, MA 02421-4988
Phone
(781) 861-0608
Fax
(781) 861-0608
NPI assigned
Nov 8, 2010
Last updated
Nov 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Dr. Silva Andonyan, D.M.DNPI 1104143171
Title
Dentist
Phone
(781) 861-0608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 18996 MA Primary

Addresses

Primary practice location

16 Clarke St
Lexington, MA 02421-4988

Mailing address

16 Clarke St
Lexington, MA 02421-4988
Phone (781) 861-0608

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1841591740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CLARKE ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214988",
            "telephone_number": "781-861-0608",
            "fax_number": "781-861-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CLARKE ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214988",
            "telephone_number": "781-861-0608",
            "fax_number": "781-861-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE STREET FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "ANDONYAN",
        "authorized_official_first_name": "SILVA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-861-0608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "18996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.