Individual provider Active NPI

Stephen Michael Saracino, DMD

  • General Practice Dentistry
  • Raynham, MA
National Provider Identifier
1073610762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16388 Issued in MA
Practice address
1244 Broadway
Raynham, MA 02767-1973
Phone
(508) 880-4910
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16388 MA Primary

Addresses

Primary practice location

1244 Broadway
Raynham, MA 02767-1973

Mailing address

1244 Broadway
Raynham, MA 02767-1973
Phone (508) 880-4910

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
I20160112001486 MA Order and Referring Only - DentistPractitioner - Dentist 5496057127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16388MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073610762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 BROADWAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671973",
            "telephone_number": "508-880-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 BROADWAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671973",
            "telephone_number": "508-880-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARACINO",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

Verify at the official NPI Registry.