DEDHAM MEDICAL ASSOC INC NPI 1164422234

NPI Information

  • NPI: 1164422234
  • Provider Name: DEDHAM MEDICAL ASSOC INC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1 LYONS ST
    DEDHAM, MA
    ZIP 02026
  • Phone: (781) 329-1400

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NPI Details

DEDHAM MEDICAL ASSOC INC is a general practice dentist in Dedham, 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. DEDHAM MEDICAL ASSOC INC NPI is 1164422234. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 LYONS ST
DEDHAM, MA
ZIP 02026-599
Phone: (781) 329-1400
Fax: (781) 278-5667

The provider's authorized official is Richard M Russo .
The authorized official title is Cfo and has the following contact phone number (781) 278-5540.

The enumeration date for this NPI number is 7/29/2005 and was last updated on 7/21/2022.

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 PracticeMASSACHUSETTSYes

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
19766553MEDICAIDMASSACHUSETTS
29766634MEDICAIDMASSACHUSETTS
39766529MEDICAIDMASSACHUSETTS
49766596MEDICAIDMASSACHUSETTS
59766537MEDICAIDMASSACHUSETTS
69766588MEDICAIDMASSACHUSETTS
79766545MEDICAIDMASSACHUSETTS
89766618MEDICAIDMASSACHUSETTS
99766561MEDICAIDMASSACHUSETTS
109766626MEDICAIDMASSACHUSETTS

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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