PEDIATRIC DENTAL GROUP NPI 1447700497

NPI Information

  • NPI: 1447700497
  • Provider Name: PEDIATRIC DENTAL GROUP
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • Address: 1 E MAIN ST STE 104
    NORTHBOROUGH, MA
    ZIP 01532
  • Phone: (508) 473-5437

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NPI Details

PEDIATRIC DENTAL GROUP is a point of service in Northborough, MA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PEDIATRIC DENTAL GROUP NPI is 1447700497. The provider is registered as an organization entity type.

The provider's business location address is:

1 E MAIN ST STE 104
NORTHBOROUGH, MA
ZIP 01532-662
Phone: (508) 473-5437

The provider's authorized official is Joanne Tavano .
The authorized official title is Chief Operating Officer and has the following contact phone number (978) 580-1524.

The enumeration date for this NPI number is 10/13/2016 and was last updated on 9/13/2023.

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
1305S00000XPoint of ServiceMASSACHUSETTSYes

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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