WELLINGTON CIRCLE DENTAL PC
NPI 1477667079
Dentist - General Practice 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
- General Practice
- 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 general practice . The healthcare provider is registered in the NPI registry with number 1477667079 assigned on August 2006. The practitioner's primary taxonomy code is 1223G0001X with license number 19475 (MA). The provider is registered as an organization and their NPI record was last updated 5 years ago. Wellington Circle Dental Pc operates as a multi-specialty business group with one or more individual providers 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
- 08-22-2020
- 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 General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 19475
- License State
- MA
- Taxonomy Description
- A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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) |
|---|
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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 6 | 6 | 7 | 0 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 12 | 6 | 14 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 2 + 6 + 1 + 4 + 0 + 1 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1477667079 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
JUNGWOO LEE DMD
Dentist
616 FELLSWAY
2ND FL
MEDFORD, MA
ZIP 02155
DR. PAUL K. KANG D.M.D.
Dentist
(General Practice)
616 FELLSWAY
APT 14
MEDFORD, MA
ZIP 02155
JIEUN CHA DMD
Dentist
616 FELLSWAY
MEDFORD, MA
ZIP 02155
ZAKI M MUKDISSI DMD PC
Dentist
(General Practice)
616 FELLSWAY
SECOND FLOOR
MEDFORD, MA
ZIP 02155
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 1223G0001X and a focus in General Practice.
