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MATTAPAN SMILES YOUTH DENTISTRY, LLC
NPI 1619065901
Dentist - General Practice in Mattapan, MA

Active since October 11, 2006
90 RIVER ST, MATTAPAN, MA 02126(617) 698-5437(617) 698-5435 Get Directions Write a Review

NPPES record last updated: July 9, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mattapan Smiles Youth Dentistry, Llc NPPES

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

MATTAPAN SMILES YOUTH DENTISTRY, LLC (NPI 1619065901) is a healthcare organization registered as a general practice in Mattapan, Massachusetts and active in the NPI registry since October 2006. The organization lists Jenell Stump, Manager, Licensing & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1619065901
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMATTAPAN SMILES YOUTH DENTISTRY, LLC
Location Address90 RIVER STMattapan, MA 02126-2914
Mailing Address16 Arcade Unit 198747Nashville, TN 37219-1994 · (615) 750-0343 · Fax (615) 986-1705
Phone(617) 698-5437
Fax(617) 698-5435
Organization SubpartNo
Authorized OfficialJenell StumpManager, Licensing & Credentialing · (615) 750-0343
Enumeration DateOctober 11, 2006
Last NPPES UpdateJuly 9, 2014
✔ NPI 1619065901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
90 RIVER ST, Mattapan, MA 02126
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Other Identifiers 2

Medicaid9753231MA
Medicaid110070846AMA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 16

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

MUNIRA YUSUF
Dentist
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437
BINGLAN XUE DMD
Dentist (Orthodontics and Dentofacial Orthopedics)
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437
RANDAL W COLE DMD
Dentist (General Practice)
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437
COURTNEY E IFTIGER DPT
Physical Therapist
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 298-2225
NEW ENGLAND FAMILY DENTISTRY, PC
Point of Service
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437
YOUN JOO PARK
Dentist (General Practice)
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437
WALGREEN CO
Pharmacy
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 298-6634
RUPAL KARANI DMD
Dentist (General Practice)
90 RIVER ST
MATTAPAN, MA 02126
Suffolk County (617) 698-5437

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 Mattapan Smiles Youth Dentistry, LLC's NPI number?

The NPI number for Mattapan Smiles Youth Dentistry, LLC is 1619065901. It was assigned to this organization in the NPPES registry on October 11, 2006.

Where is Mattapan Smiles Youth Dentistry, LLC located?

Mattapan Smiles Youth Dentistry, LLC is located at 90 River St, Mattapan, MA 02126. The listed phone number is (617) 698-5437.

What is Mattapan Smiles Youth Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Mattapan Smiles Youth Dentistry, LLC was last updated on July 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.