Pediatric Dental Center of Mansfield

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL CENTER OF MANSFIELD

Practice address

1029 Pleasant St
Suite 103
Bridgewater, MA 02324-2301

Phone

(508) 337-3307

NPI assigned

Jan 6, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Robert Joseph Moreau Sr., DMD

Title

Owner/Dentist

Phone

(508) 337-3307

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dental Center-Bridgewater Doing business as

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.

• Pediatric Dental Center of Mansfield

  • Dental Clinic/Center
  • Mansfield, MA
  • NPI 1982876942
  NPD tax ID

Locations

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"
        }
    ]
}

• Lucky Osawonuyi
• Tiffany Palenscar, PT
• Ann Michele Parks, MA, MSW, LICSW
• Bidhin Ramanlal Patel, DMD
• Karen Lynn Peabody, LICSW
• George Pelayo, DMD
• Wendy Beth Penniman, PTA
• Amy Grace Pereira, BA
• Kaitlyn Peretti, PSY.D.
• Kevin A Perry, D.C.

• Pediatric Dentistry in Bridgewater, MA
• Providers in Bridgewater, MA by specialty
• Pediatric Dentistry in Massachusetts

• 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.