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NPI Code Detail

MEDICARE: NAN E NILAND DDS

MEDICARE: NAN E NILAND DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry14447MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114447OTHERDELTA DENTAL
2DMA772OTHERHARVARD PILGRIM POS
3X04454OTHERDENTAL BLUE
4DMA772OTHERHARVARD/PILGRIM
50016779OTHERNEIGHBORHOOD HEALTH PLAN
6DMA772OTHERHARVARD PILGRIM PPO
7DMA772OTHERFIRST SENIORITY

General Provider Information

NPI Number : 1790782324
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAN E NILAND DDS
Provider Business Mailing Address
First Line : 400 COMMONWEALTH AVE
Second Line :
City : BOSTON
State : MA
Zip : 02215-2813
Country : US
Telephone Number : 781-329-1400
Fax Number : 781-278-5667
Provider Business Practice Location Address
First Line : 1 LYONS ST
Second Line :
City : DEDHAM
State : MA
Zip : 02026-5599
Country : US
Telephone Number : 781-329-1400
Fax Number : 781-278-5667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 03/21/2016

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1205832821 — JENNIFER K FEHSER MD
Practice Location Address:
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1811993447 — MICHAEL FERRIS MD
Practice Location Address:
1 LYONS ST
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1659378289 — TERRI LOEWENTHAL CCC-A
Practice Location Address:
1 LYONS ST
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Directions to “ NAN E NILAND DDS” Practice Location

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