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PREMIER FAMILY DENTISTRY LLC NPI 1689232936


NPI Information

NPI: 1689232936
Provider Name: PREMIER FAMILY DENTISTRY LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
39 CROSS ST STE 101
PEABODY, MA
ZIP 01960
Phone: (978) 532-7177
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PREMIER FAMILY DENTISTRY LLC is a dental clinic center in Peabody, MA. PREMIER FAMILY DENTISTRY LLC NPI is 1689232936. The provider is registered as an organization entity type.

The provider's business location address is:

39 CROSS ST STE 101
PEABODY, MA
ZIP 01960-666
Phone: (978) 532-7177
Fax: (978) 531-9939

The provider's authorized official is Rani Varghese .
The authorized official title is Dentist and has the following contact phone number (978) 532-7177.

The enumeration date for this NPI number is 6/2/2019 and was last updated on 8/26/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDentalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11205199569MEDICAIDMASSACHUSETTS

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: 4/28/2024

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