NPIMap

Organization Active NPI

Pondside Associates, LLC

  • Dental Clinic/Center
  • Jamaica Plain, MA
National Provider Identifier
1912188574
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
20059 Issued in MA
Legal business name
PONDSIDE ASSOCIATES, LLC
Practice address
793 Centre St
Jamaica Plain, MA 02130-2736
Phone
(617) 522-1970
NPI assigned
Nov 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Authorized official

Name
Dr. John Tieu, D.D.S
Title
Owner/ Dentist
Phone
(617) 522-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 20059 MA Primary

Addresses

Primary practice location

793 Centre St
Jamaica Plain, MA 02130-2736

Mailing address

P.O.Box 301697
Jamaica Plain, MA 02130
Phone (617) 522-1970

National Provider Directory

National Provider Directory

Locations

793 Centre St
Jamaica Plain, MA 02130
Phone (617) 522-1970

Practitioners & affiliated clinicians

Practitioners 6

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": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1912188574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 301697",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "617-522-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302736",
            "telephone_number": "617-522-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDSIDE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "TIEU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "617-522-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "20059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.