Elizabeth Blake Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN1855332 Issued in MA

Legal business name

ELIZABETH BLAKE ORTHODONTICS LLC

Practice address

77 Main St
Hopkinton, MA 01748-3118

Phone

(352) 262-9532

NPI assigned

Dec 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth Blake Peluso, DMD, MDS

Title

Orthodontist

Phone

(352) 262-9532

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1013253061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SILVA ST",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573476",
            "telephone_number": "352-262-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MAIN ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017483118",
            "telephone_number": "352-262-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH BLAKE ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "PELUSO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "352-262-9532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN1855332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Hopkinton, MA
• Providers in Hopkinton, MA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.