WELLINGTON CIRCLE DENTAL PC
NPI 1477667079
Dentist - Prosthodontics in Medford, MA
NPI Status: Active since August 19, 2006
Contact Information
616 FELLSWAY
SECOND FLOOR
MEDFORD, MA
ZIP 02155
Phone: (781) 306-9644
Fax: (781) 306-9726
- Organization
- Dentist
- Prosthodontics
- CLIA Number: 22D0926928
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 04-03-2027
About WELLINGTON CIRCLE DENTAL PC
This page provides the complete NPI Profile along with additional information for Wellington Circle Dental Pc, a provider established in Medford, Massachusetts operating as a Dentist, focusing in prosthodontics . The healthcare provider is registered in the NPI registry with number 1477667079 assigned on August 2006. The practitioner's primary taxonomy code is 1223P0700X with license number 21063 (MA). The provider is registered as an organization and their NPI record was last updated one year ago. Wellington Circle Dental Pc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Zaki M Mukdissi Dmd (President Owner)
- NPI
- 1477667079
- Provider Name
- WELLINGTON CIRCLE DENTAL PC
- Entity Type
- Organization
- Location Address
- 616 FELLSWAY SECOND FLOOR MEDFORD, MA 02155
- Location Phone
- (781) 306-9644
- Location Fax
- (781) 306-9726
- Mailing Address
- 616 FELLSWAY SECOND FLOOR MEDFORD, MA 02155
- Mailing Phone
- (781) 306-9644
- Mailing Fax
- (781) 306-9726
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-19-2006
- Last Update Date
- 09-11-2025
- Code Navigator
A dentist like Wellington Circle Dental Pc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Prosthodontics
- Taxonomy Code
- 1223P0700X
- Type
- Dental Providers
- License No.
- 21063
- License State
- MA
- Taxonomy Description
- That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223G0001X | Dental Providers | Dentist | 19475 (MA) |
| 2 | 1223P0300X | Dental Providers | Dentist | 19255 (MA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 22D0926928
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- April 04, 2025
- Certificate Expiration Date
- April 03, 2027
- Laboratory Director
- ASHRAF SELIM MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wellington Circle Dental Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1477667079, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477667079, enumerated as an "organization" on August 19, 2006.
The provider is located at 616 FELLSWAY SECOND FLOOR MEDFORD, MA 02155 and the phone number is (781) 306-9644.
Dentist with taxonomy code 1223P0700X and a focus in Prosthodontics.
