IK PERIO PLLC NPI 1780593863

NPI Information

  • NPI: 1780593863
  • Provider Name: IK PERIO PLLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 131 MAIN ST
    WALTHAM, MA
    ZIP 02453
  • Phone: (781) 647-0618

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NPI Details

IK PERIO PLLC is a dental clinic center in Waltham, MA. IK PERIO PLLC NPI is 1780593863. The provider is registered as an organization entity type.

The provider's business location address is:

131 MAIN ST
WALTHAM, MA
ZIP 02453-636
Phone: (781) 647-0618

The provider's authorized official is Isaac Kim .
The authorized official title is Owner Periodontist and has the following contact phone number (617) 583-0015.

The enumeration date for this NPI number is 9/3/2026 and was last updated on 9/24/2026.

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
1261QD0000XClinic/CenterDentalYes

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

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