CONVIVIAL DENTAL PC – NPI #1689007908
Clinic/Center

CONVIVIAL DENTAL PC is an AHC clinic located in CHESTNUT HILL, MA. NPPES has assigned the NPI number 1689007908 to CONVIVIAL DENTAL PC on August 11, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CONVIVIAL DENTAL PC below.

NPI Profile for
CONVIVIAL DENTAL PC

NPI Number
1689007908
Enumeration Date

(about 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CONVIVIAL DENTAL PC
Primary location
1244 BOYLSTON ST STE 205
CHESTNUT HILL, MA 02467-2115
Phone: (617) 818-0573 Fax:
Mailing address
64 PINE ST
DOVER, MA 02030-2426
Phone: Fax:
Organization Subpart
No
Authorized Official
ATHANASIOS ZAVRAS
PRESIDENT
Phone: (617) 818-0573
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 MA DN1855922
261QM1300X
- Clinic/Center / Multi-Specialty		 MA DN1855922

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.