Stellar Smiles Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STELLAR SMILES FAMILY DENTAL LLC

Doing business as

Hathorne Family Dental

Practice address

491 Maple St Ste 302
Danvers, MA 01923-4026

Phone

(703) 953-4088

NPI assigned

Mar 5, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Keerthy Reddy Chilakamarry, DMDNPI 1770092389

Title

Owner

Phone

(781) 606-2148

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hathorne Family Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keerthy Chilakamarry, DMD

  • Dentist
  • Lawrence, MA
  • NPI 1770092389

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1902663933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 MAPLE ST STE 302",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234026",
            "telephone_number": "703-953-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 MAPLE ST STE 302",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234026",
            "telephone_number": "703-953-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR SMILES FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "CHILAKAMARRY",
        "authorized_official_first_name": "KEERTHY",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-606-2148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DN1857756",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hathorne Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Staszak, MOT, OTR/L
• Kimberly E Steele
• Undrea Cato- Steele, M.ED., BCBA
• Gina Marie Stefanowicz, MED
• Jeffrey D Stein, PH.D.
• Nicholas P Stelmach, MA
• Allison Stenson
• Seleah Sterling
• Steven a. Corben, D.M.D., LTD.
• Dylan Matthew Stevens, CSCS

• General Practice Dentistry in Danvers, MA
• Providers in Danvers, 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 Mar 5, 2024; 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.