OrganizationActive
Aqua Dental LLC
NPI 1336392505 · Dental Clinic/Center · Randolph, MA
Provider details
- NPI number
- 1336392505
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jeffrey Fayerman, Owner(781) 963-6077
- License
- 18450 (MA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1395 N Main St
Randolph, MA 02368-1768
Phone: (781) 963-6077
Street-level locationGet directions
Mailing address
1395 N Main St
Randolph, MA 02368-1768
Registry dates
- Enumerated
- 2008-10-31
- Last updated
- 2008-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.