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Contact Information

RANDOLPH SMILES LLC
56 SOUTH MAIN STREET
RANDOLPH, MA02368
 Phone: 508-676-8268
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for RANDOLPH SMILES LLC

NPI Number 1043752074
LBN Legal business name RANDOLPH SMILES LLC
Authorized official RAMESH IZEDIAN - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2016
Last updated 11/08/2016 - About 10 years ago
Identifiers
MA License # 18174
MA Medicaid 280712
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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