Provider Demographics
NPI:1043421225
Name:ST JAY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ST JAY ASSOCIATES, INC.
Other - Org Name:DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAYAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:THIAGARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-837-4444
Mailing Address - Street 1:14 MAYFLOWER RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4239
Mailing Address - Country:US
Mailing Address - Phone:978-837-4444
Mailing Address - Fax:
Practice Address - Street 1:234 ESSEX ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1549
Practice Address - Country:US
Practice Address - Phone:978-837-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9708031Medicaid