Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Back Bay Dental Group LLC

Organization Dentist · NPI 1063758639

Back Bay Dental Group LLC is a Dentist in Boston, Massachusetts. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

21 Bay State Rd
Boston, MA 02215-2101
Phone: (617) 247-9966
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1063758639
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Miller — President · (617) 921-6292
NPI enumeratedDecember 29, 2012
Last updated in NPPESJanuary 3, 2013
Mailing address21 Bay State Rd, Boston, MA 02215-2101

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