ICON DPMG LLC NPI 1134331424

NPI Information

NPI: 1134331424
Provider Name: ICON DPMG LLC
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
Doing Business As: ICON DENTAL
Address: 57 BEDFORD STREET
SUITE 220
LEXINGTON, MA
ZIP 02420
Phone: (781) 861-6401

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NPI Details

ICON DPMG LLC is a general practice dentist in Lexington, 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. ICON DPMG LLC NPI is 1134331424. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Icon Dental.

The provider's business location address is:

57 BEDFORD STREET
SUITE 220
LEXINGTON, MA
ZIP 02420
Phone: (781) 861-6401
Fax: (781) 861-6258

The provider's authorized official is Hyung-jung Ahn .
The authorized official title is Owner/director and has the following contact phone number (781) 861-6401.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 9/12/2011.

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
1	1223G0001X	Dentist	General Practice			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9701010	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	MASS HEALTH

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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