Individual provider Active NPI

Stacy Temple, D.M.D.

  • Dentist
  • Quincy, MA
National Provider Identifier
1073824843
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855737 Issued in MA
Practice address
1261 Furnace Brook Pkwy Ste 12a
Quincy, MA 02169-4762
Phone
(617) 472-3700
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL10955 MA
Dentist 122300000X DN1855737 MA Primary

Addresses

Primary practice location

1261 Furnace Brook Pkwy Ste 12a
Quincy, MA 02169-4762

Mailing address

1261 Furnace Brook Pkwy Ste 12a
Quincy, MA 02169-4762
Phone (617) 472-3700

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
I20150414001651 MA Order and Referring Only - DentistPractitioner - Dentist 9739407271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL10955MAMDDentist
DN1855737MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Family Dentistry PLLC CurrentSince Jun 18, 2023 Accepting new patients

Locations

1261 Furnace Brook Pkwy
Ste 12A
Quincy, MA 02169
Phone (617) 472-3700

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686960000000",
    "number": "1073824843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 FURNACE BROOK PKWY STE 12A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694762",
            "telephone_number": "617-472-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 FURNACE BROOK PKWY STE 12A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694762",
            "telephone_number": "617-472-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "STACY",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL10955",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.