NPIMap

Organization Active NPI

Dental Studio Associates, LLC

  • General Practice Dentistry
  • Agawam, MA
National Provider Identifier
1093871469
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20289 Issued in MA
Legal business name
DENTAL STUDIO ASSOCIATES, LLC
Practice address
302 Suffield St
Agawam, MA 01001-1749
Phone
(413) 786-0085
Fax
(413) 786-0025
NPI assigned
Dec 29, 2006
Last updated
Dec 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Authorized official

Name
Mrs. Jennifer Lynn Boutet
Title
Office Manager
Phone
(413) 786-0085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20289 MA Primary

Addresses

Primary practice location

302 Suffield St
Agawam, MA 01001-1749

Mailing address

302 Suffield St
Agawam, MA 01001-1749
Phone (413) 786-0085

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1093871469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 SUFFIELD ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011749",
            "telephone_number": "413-786-0085",
            "fax_number": "413-786-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SUFFIELD ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011749",
            "telephone_number": "413-786-0085",
            "fax_number": "413-786-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL STUDIO ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "BOUTET",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "413-786-0085",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.