NPIMap

Organization Active NPI

Elissa Heard DMD PC

  • General Practice Dentistry
  • Quincy, MA
National Provider Identifier
1013060235
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13671 Issued in MA
Legal business name
ELISSA HEARD DMD PC
Practice address
111 Willard St 1B
Quincy, MA 02169
Phone
(617) 471-8640
Fax
(617) 471-9328
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Elissa Heard, DMDNPI 1407917552
Title
Dentist Owner
Phone
(617) 471-8640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 13671 MA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 17259 MA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 16163 MA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 21465 MA

Addresses

Primary practice location

111 Willard St 1B
Quincy, MA 02169

Mailing address

111 Willard St 1B
Quincy, MA 02169
Phone (617) 471-8640

Other identifiers 2

IdentifierTypeStateIssuer
1131OtherDELTA
4983OtherBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013060235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST 1B",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-471-8640",
            "fax_number": "617-471-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST 1B",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02169",
            "telephone_number": "617-471-8640",
            "fax_number": "617-471-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISSA HEARD DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEARD",
        "authorized_official_first_name": "ELISSA",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "617-471-8640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13671",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17259",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16163",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "1131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.