Individual provider Active NPI

Michael Tabbah, DMD

  • Dentist
  • West Bridgewater, MA
National Provider Identifier
1043304272
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20277 Issued in MA
Practice address
345 W Center St
Suite 1
West Bridgewater, MA 02379-1600
Phone
(508) 894-8100
Fax
(508) 894-8101
NPI assigned
Oct 3, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20277 MA Primary

Addresses

Primary practice location

345 W Center St
Suite 1
West Bridgewater, MA 02379-1600

Mailing address

345 West Center St
Ste 1
West Bridgewater, MA 02379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506000509 MA Order and Referring Only - DentistPractitioner - Dentist 1456650829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20277MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Smiles PC Dentist CurrentSince Mar 13, 2022 Accepting new patients

Locations

120 W Center St
Ste 1
West Bridgewater, MA 02379

345 W Center St
Ste 1
West Bridgewater, MA 02379
Phone (508) 894-8100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1043304272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WEST CENTER ST",
            "address_2": "STE 1",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "02379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W CENTER ST",
            "address_2": "SUITE 1",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023791600",
            "telephone_number": "508-894-8100",
            "fax_number": "508-894-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABBAH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-03-10",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bridgewater, MA

Sources for this page

Verify at the official NPI Registry.