Provider Demographics
NPI:1295481463
Name:INSPIRED DENTAL PC
Entity type:Organization
Organization Name:INSPIRED DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VI
Authorized Official - Middle Name:TUONG
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-309-8351
Mailing Address - Street 1:400 LINCOLN ST # 21
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:87 MEDFORD ST APT C4
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-6500
Practice Address - Country:US
Practice Address - Phone:781-836-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty