NPIMap

Organization Active NPI

Randolph Dental Group LLC

  • Dentist
  • Randolph, MA
National Provider Identifier
1972067072
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RANDOLPH DENTAL GROUP LLC
Practice address
1 Frank Leary Way Unit 4
Randolph, MA 02368-4503
Phone
(781) 963-7204
NPI assigned
Jan 23, 2019
Organization subpart
Yes
Parent organization
RANDOLPH DENTAL GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Jane Chaney
Title
Senior Accountant
Phone
(781) 562-0469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1 Frank Leary Way Unit 4
Randolph, MA 02368-4503

Mailing address

500 Chapman St Unit 201
Canton, MA 02021-2040

National Provider Directory

National Provider Directory
Tax ID family
Randolph Dental Group LLC3 organizations share this tax ID, including this one
Part of
Randolph Dental Group LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1972067072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CHAPMAN ST UNIT 201",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FRANK LEARY WAY UNIT 4",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684503",
            "telephone_number": "781-963-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH DENTAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RANDOLPH DENTAL GROUP LLC",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "CHANEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "SENIOR ACCOUNTANT",
        "authorized_official_telephone_number": "781-562-0469"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.