PERIODONTOLOGY ASSOC NPI 1407964901

NPI Information

  • NPI: 1407964901
  • Provider Name: PERIODONTOLOGY ASSOC
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 290 BAKER AVE
    S103
    CONCORD, MA
    ZIP 01742
  • Phone: (978) 369-5521

Map and Directions

Get Directions

NPI Details

PERIODONTOLOGY ASSOC is a periodontics dentist in Concord, MA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTOLOGY ASSOC NPI is 1407964901. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

290 BAKER AVE
S103
CONCORD, MA
ZIP 01742
Phone: (978) 369-5521
Fax: (978) 369-5591

The provider's authorized official is Jeffrey B Freedman .
The authorized official title is Owner and has the following contact phone number (978) 369-5521.

The enumeration date for this NPI number is 8/26/2006 and was last updated on 8/22/2020.

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
11223P0300XDentistPeriodontics19000MASSACHUSETTSNo
21223P0300XDentistPeriodontics13998MASSACHUSETTSYes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI