Modestow Family Dentistry PC

Primary specialty

DentistTaxonomy code 122300000X

License

20017 Issued in MA

Legal business name

MODESTOW FAMILY DENTISTRY PC

Practice address

190 Nonotuck Street
Suite 101
Florence, MA 01062-1934

Phone

(413) 586-5887

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Michelle Kersbergen

Title

Business Administrator

Phone

(413) 586-5887

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1053842245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 NONOTUCK STREET",
            "address_2": "SUITE 101",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621934",
            "telephone_number": "413-586-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 NONOTUCK STREET",
            "address_2": "SUITE 101",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010621934",
            "telephone_number": "413-586-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTOW FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "KERSBERGEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "413-586-5887",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "20017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank T. Meyers, MD
• Scott R Meyers, PSY.D.
• Melissa Michalski, MS
• Virginia L Miller, CNM
• Mary E Mitchell
• Ian E Modestow, DMD
• Katherine Moeller, LICSW
• Abigail Moore, MSW, LICSW
• Chloe Helene Mortelliti, RDN
• Susan J. Mosler, MD

• Dentist in Florence, MA
• Providers in Florence, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.