Active NPI
Pallonji Maneck Bhiladvala, DMD,MSD,FACD,FICD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Andover, MA
National Provider Identifier
1083628358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 9628
- Practice address
- 7 Agawam LN
Andover, MA 01810-5203 - Phone
- (978) 475-8000
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 9628 | MA | Primary |
Addresses
Primary practice location
7 Agawam LN
Andover, MA 01810-5203
Mailing address
7 Agawam LN
Andover, MA 01810-5203
Phone (978) 475-8000
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 |
|---|---|---|---|
| 9628 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083628358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 AGAWAM LN",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018105203",
"telephone_number": "978-475-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 AGAWAM LN",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018105203",
"telephone_number": "978-475-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHILADVALA",
"first_name": "PALLONJI",
"middle_name": "MANECK",
"name_prefix": "Dr.",
"credential": "DMD,MSD,FACD,FICD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MA",
"license": "9628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, 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.