NPIMap

Organization Active NPI

Prosthodontics, P.C.

  • Prosthodontics
  • Beverly, MA
National Provider Identifier
1053517037
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
17559 Issued in MA
Legal business name
PROSTHODONTICS, P.C.
Practice address
16 Enon St
Beverly, MA 01915-1116
Phone
(978) 922-6726
Fax
(978) 922-6727
NPI assigned
Jun 26, 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
Ms. Mary-Lou Courcelle
Title
Office Manager
Phone
(978) 922-6726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X 17559 MA Primary

Addresses

Primary practice location

16 Enon St
Beverly, MA 01915-1116

Mailing address

16 Enon St
Beverly, MA 01915-1116
Phone (978) 922-6726

Other names 1

  • Dr. Herman Strating Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053517037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151116",
            "telephone_number": "978-922-6726",
            "fax_number": "978-922-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151116",
            "telephone_number": "978-922-6726",
            "fax_number": "978-922-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COURCELLE",
        "authorized_official_first_name": "MARY-LOU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "978-922-6726",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "17559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Herman Strating",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly, 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.