NPIMap

Organization Active NPI

Pediatric Dental Center of Mansfield

Doing business as Pediatric Dental Center-Bridgewater

  • Pediatric Dentistry
  • Bridgewater, MA
National Provider Identifier
1003272006
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL CENTER OF MANSFIELD
Doing business as
Pediatric Dental Center-Bridgewater
Practice address
1029 Pleasant St
Suite 103
Bridgewater, MA 02324-2301
Phone
(508) 337-3307
NPI assigned
Jan 6, 2016
Last updated
Jan 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Joseph Moreau Sr., DMDNPI 1225160138
Title
Owner/Dentist
Phone
(508) 337-3307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1029 Pleasant St
Suite 103
Bridgewater, MA 02324-2301

Mailing address

1029 Pleasant St
Suite 103
Bridgewater, MA 02324-2301

Other names 1

  • Pediatric Dental Center-Bridgewater Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Dental Center of Mansfield2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1029 Pleasant St
Ste 103
Bridgewater, MA 02324
Phone (508) 337-3307

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1003272006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 PLEASANT ST",
            "address_2": "SUITE 103",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 PLEASANT ST",
            "address_2": "SUITE 103",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242301",
            "telephone_number": "508-337-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL CENTER OF MANSFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "MOREAU",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "508-337-3307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Center-Bridgewater",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgewater, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.