Active NPI
Theresa Garrido Carunungan, D.M.D.
- General Practice Dentistry
- Concord, MA
National Provider Identifier
1043428360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17950
- Practice address
- 747 Main St
Suite 211
Concord, MA 01742-3302 - Phone
- (978) 369-2877
- Fax
- (209) 671-6510
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17950 | MA | Primary |
Addresses
Primary practice location
747 Main St
Suite 211
Concord, MA 01742-3302
Mailing address
747 Main St
Suite 211
Concord, MA 01742-3302
Phone (978) 369-2877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17950 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043428360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 MAIN ST",
"address_2": "SUITE 211",
"city": "CONCORD",
"state": "MA",
"postal_code": "017423302",
"telephone_number": "978-369-2877",
"fax_number": "209-671-6510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 MAIN ST",
"address_2": "SUITE 211",
"city": "CONCORD",
"state": "MA",
"postal_code": "017423302",
"telephone_number": "978-369-2877",
"fax_number": "209-671-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARUNUNGAN",
"first_name": "THERESA",
"middle_name": "GARRIDO",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "17950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.