T.P.Deahl D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16574 Issued in MA

Legal business name

T.P.DEAHL D.D.S., P.C.

Practice address

2286 Massachusetts Ave
Cambridge, MA 02140-1812

Phone

(617) 868-4046

Fax

(617) 868-5375

NPI assigned

Sep 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Paul Deahl, D.D.S.NPI 1508882028

Title

President

Phone

(617) 868-4046

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Timothy Paul Deahl, DDS

  • General Practice Dentistry
  • Cambridge, MA
  • NPI 1508882028
  NPD (past) Authorized official
• Connie Wang Marcusa, DDS

  • Prosthodontics
  • Quincy, MA
  • NPI 1477077139
  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1952595696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2286 MASSACHSUETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02140",
            "telephone_number": "617-868-4046",
            "fax_number": "617-868-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2286 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401812",
            "telephone_number": "617-868-4046",
            "fax_number": "617-868-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.P.DEAHL D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "DEAHL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-868-4046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Synrise Wellness LLC
• Gabriel Szentpaly, M.D.
• Alexander Szewczyk
• Jennifer Ta Slatkavitz
• Michaela Ta, PHARMD
• Khali Mariama Tabor
• Margaret Ann Tabor, D.C.
• Malaika Tabors, MSPT, LIC AC., M. AC

• General Practice Dentistry in Cambridge, MA
• Providers in Cambridge, 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 Sep 5, 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.