Provider Demographics
NPI:1982873469
Name:ALLEN K. NIUKIAN D.M.D.
Entity Type:Organization
Organization Name:ALLEN K. NIUKIAN D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NIUKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-923-0706
Mailing Address - Street 1:521 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4191
Mailing Address - Country:US
Mailing Address - Phone:617-923-0706
Mailing Address - Fax:617-923-0706
Practice Address - Street 1:521 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4191
Practice Address - Country:US
Practice Address - Phone:617-923-0706
Practice Address - Fax:617-923-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty