Provider Demographics
NPI:1851469555
Name:DEXTERITY SURGICAL, LLC
Entity type:Organization
Organization Name:DEXTERITY SURGICAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-721-0500
Mailing Address - Street 1:100 UNICORN PARK DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:781-721-0500
Mailing Address - Fax:781-721-5719
Practice Address - Street 1:100 UNICORN PARK DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:781-721-0500
Practice Address - Fax:781-721-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218005174400000X
MA2082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21873Medicare UPIN