1386710812 NPI number — DR. RAYMOND VINCENT DEMPSEY DMD

Table of content: DR. RAYMOND VINCENT DEMPSEY DMD (NPI 1386710812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386710812 NPI number — DR. RAYMOND VINCENT DEMPSEY DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEMPSEY
Provider First Name:
RAYMOND
Provider Middle Name:
VINCENT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386710812
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 NORTH BEACON STREET
Provider Second Line Business Mailing Address:
APT 715
Provider Business Mailing Address City Name:
ALLSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-783-1904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
921 MASSACHUSETTES AVENUE
Provider Second Line Business Practice Location Address:
CANBRIDGE DENTAL ASSOCIATES
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-492-8210
Provider Business Practice Location Address Fax Number:
617-876-7390
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  19917 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: 046211 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 2222 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com