Healthcare Provider Details

I. General information

NPI: 1295651859
Provider Name (Legal Business Name): ALIGN PEDIATRIC DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BAY STATE RD UNIT B
BOSTON MA
02215-2138
US

IV. Provider business mailing address

909 HANCOCK ST
QUINCY MA
02170-3827
US

V. Phone/Fax

Practice location:
  • Phone: 617-203-7382
  • Fax:
Mailing address:
  • Phone: 617-203-7382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: YONG DING
Title or Position: OWNER
Credential: DMD
Phone: 508-361-9589