CDG BACK BAY LLC

Address: 400 Commonwealth Ave 3rd Floor, Boston, MA 02215
Phone: 6172668770

CDG BACK BAY LLC (NPI# 1114533866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114533866
Entity Type Organization
Organization Name CDG BACK BAY LLC
Practice Address 400 Commonwealth Ave 3rd Floor
Boston
MA 02215
Practice Telephone 6172668770
Practice Fax Number 6172669530
Mailing Telephone 6172668770
Mailing Fax Number 6172669530
Enumeration Date 2020-09-18
Last Update Date 2020-09-18
Authorized Official Name MS. CHRISTY LYNETTE LUKASAVAGE (DIRECTOR OF OPERATIONS)
Authorized Official Telephone 6172668770
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Commonwealth Dental Group Doing Business As Name - Organization

Office Location

Street Address 400 COMMONWEALTH AVE 3RD FLOOR
City BOSTON
State MA
Zip Code 02215

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336746775 Lee T Gernon-Lakin Physician Assistant 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 2020-10-08
1821695933 Matthew John Needham Student in an Organized Health Care Education/Training Program 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 2020-10-02
1619595105 Natasha Larocque Radiology 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 2020-07-10
1538783089 Yutsz Cherng Counselor 870r Commonwealth Avenue, Boston, MA 02215 2020-06-01
1306495924 Anthony Rosellini Psychologist 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 2019-09-06
1427605278 Liana Zucco Student in an Organized Health Care Education/Training Program Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 2019-08-26
1831759430 Brian William Hayes Radiology 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 2019-06-17
1396304358 Elizabeth Hai Yen Du Student in an Organized Health Care Education/Training Program Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 2019-06-12
1922665439 Corey Shaphard Miller Student in an Organized Health Care Education/Training Program 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 2019-05-21
1821653684 Nicola Marie Hughes Student in an Organized Health Care Education/Training Program Dana-Farber Cancer Institute, 450, Brookline Ave Radiology Department, Boston, MA 02215 2019-05-07
Find all providers in zip 02215

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407465743 Beacon Dental Health PC Clinic/Center 21 Merchants Row Ste 2a, Boston, MA 02109-2040 2020-07-22
1720642143 Akradi Dental, LLC Clinic/Center 21 Bay State Rd # 3, Boston, MA 02215-2101 2019-05-01
1124595111 Bespoke Dental Boston Clinic/Center 11 Newbury St Fl 4, Boston, MA 02116-3138 2018-10-28
1851871081 Boston Premier Dentistry, PC Clinic/Center 10 Tremont St Ste 402, Boston, MA 02108-2062 2018-08-16
1376032292 Boston Park Dental Group Clinic/Center 128a Tremont St Fl 3, Boston, MA 02108-4716 2018-05-07
1447752563 Kristen Choe Dority, Dmd, PC Clinic/Center 37 Newbury St Ste 3, Boston, MA 02116-3428 2018-03-05
1639682305 Boston Dental Partners LLC Clinic/Center 330 Martin Luther King Blvd, Boston, MA 02119-1868 2017-11-15
1831619469 Levy Family Dental LLC Clinic/Center 185 Devonshire St Ste 410, Boston, MA 02110-1413 2017-06-24
1811417603 Trinity Dental Pllc Clinic/Center 1 Huntington Ave Unit B, Boston, MA 02116-5713 2017-06-22
1710347190 Day Square Dental LLP Clinic/Center 371 Chelsea St, Boston, MA 02128-1480 2016-02-29
Find all providers in BOSTON

Competitor

Search similar providers

City BOSTON
Zip Code 02215

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.