NPIMap

Organization Active NPI

Kaddis Dental PC

  • Dentist
  • Natick, MA
National Provider Identifier
1972680932
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21602 Issued in MA
Legal business name
KADDIS DENTAL PC
Practice address
6 Dewey St
Natick, MA 01760
Phone
(508) 653-3930
Fax
(508) 653-1261
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mina Joseph KaddisNPI 1265519227
Title
Owner President
Phone
(508) 653-3930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 21602 MA Primary

Addresses

Primary practice location

6 Dewey St
Natick, MA 01760

Mailing address

6 Dewey St
Natick, MA 01760
Phone (508) 653-3930

National Provider Directory

National Provider Directory

Locations

6 Dewey St
Natick, MA 01760
Phone (508) 653-3930

Practitioners & affiliated clinicians

Practitioners 1

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972680932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 DEWEY ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "01760",
            "telephone_number": "508-653-3930",
            "fax_number": "508-653-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DEWEY ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "01760",
            "telephone_number": "508-653-3930",
            "fax_number": "508-653-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KADDIS DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KADDIS",
        "authorized_official_first_name": "MINA",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "508-653-3930"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "21602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.