WEST ROXBURY MODERN DENTISTRY PC NPI 1073299137

NPI Information

  • NPI: 1073299137
  • Provider Name: WEST ROXBURY MODERN DENTISTRY, PC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 75 SPRING ST STE 100A
    WEST ROXBURY, MA
    ZIP 02132
  • Phone: (857) 353-5103

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NPI Details

WEST ROXBURY MODERN DENTISTRY, PC is a general practice dentist in West Roxbury, MA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. WEST ROXBURY MODERN DENTISTRY, PC NPI is 1073299137. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

75 SPRING ST STE 100A
WEST ROXBURY, MA
ZIP 02132-335
Phone: (857) 353-5103
Fax: (957) 264-2506

The provider's authorized official is Frederick Lee .
The authorized official title is Owner and has the following contact phone number (857) 353-5103.

The enumeration date for this NPI number is 6/23/2023 and was last updated on 6/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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