NPIMap

Organization Active NPI

Coastal Dental Associates, LLC

  • General Practice Dentistry
  • Fairhaven, MA
National Provider Identifier
1104214451
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COASTAL DENTAL ASSOCIATES, LLC
Practice address
118 Alden Rd
Fairhaven, MA 02719-4721
Phone
(508) 994-2255
NPI assigned
Jan 8, 2015
Last updated
Jan 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Authorized official

Name
Jennifer Kuchar, DMD
Title
Co-Owner
Phone
(773) 931-2196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

118 Alden Rd
Fairhaven, MA 02719-4721

Mailing address

118 Alden Rd
Fairhaven, MA 02719-4721
Phone (508) 994-2255

National Provider Directory

National Provider Directory

Locations

118 Alden Rd
Fairhaven, MA 02719
Phone (508) 994-2255

Practitioners & affiliated clinicians

Practitioners 2

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": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1104214451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 ALDEN RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027194721",
            "telephone_number": "508-994-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 ALDEN RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027194721",
            "telephone_number": "508-994-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "KUCHAR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "773-931-2196",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.