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BACK BAY DENTAL GROUP LLC
NPI 1063758639
Dentist in Boston, MA

Active since December 29, 2012
21 BAY STATE RD, BOSTON, MA 02215(617) 247-9966 Get Directions Write a Review

NPPES record last updated: January 3, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Back Bay Dental Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BACK BAY DENTAL GROUP LLC (NPI 1063758639) is a healthcare organization registered as a dentist in Boston, Massachusetts and active in the NPI registry since December 2012. The organization lists Richard Miller, President, as its authorized official.

NPPES Registry Identity

NPI1063758639
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameBACK BAY DENTAL GROUP LLC
Location Address21 BAY STATE RDBoston, MA 02215-2101
Mailing Address21 Bay State RdBoston, MA 02215-2101
Phone(617) 247-9966
Organization SubpartNo
Authorized OfficialRichard MillerPresident · (617) 921-6292
Enumeration DateDecember 29, 2012
Last NPPES UpdateJanuary 3, 2013
✔ NPI 1063758639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
21 BAY STATE RD, Boston, MA 02215
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAUL MATHEW DDS
Dentist (General Practice)
21 BAY STATE RD
BOSTON, MA 02215
Suffolk County (617) 247-9966
DR. MARYAM DOURAGHY DMD
Dentist (General Practice)
21 BAY STATE RD
BOSTON, MA 02215
Suffolk County (617) 247-9966
BENOIT P TROTTIER III
Dentist (General Practice)
21 BAY STATE RD, #3
BOSTON, MA 02215
Suffolk County (802) 318-2643

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Back Bay Dental Group LLC's NPI number?

The NPI number for Back Bay Dental Group LLC is 1063758639. It was assigned to this organization in the NPPES registry on December 29, 2012.

Where is Back Bay Dental Group LLC located?

Back Bay Dental Group LLC is located at 21 Bay State Rd, Boston, MA 02215. The listed phone number is (617) 247-9966.

What is Back Bay Dental Group LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Back Bay Dental Group LLC was last updated on January 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.