Main Street Dental

Primary specialty

DentistTaxonomy code 122300000X

License

19314 Issued in MA

Legal business name

MAIN STREET DENTAL

Practice address

207 Upper Main St
Edgartown, MA 02539-5927

Phone

(508) 939-9000

Fax

(508) 939-8537

NPI assigned

Jan 21, 2010

Last updated

Jan 21, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Clyde Hartley, DDS

Title

Owner

Phone

(508) 939-9000

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Glenn R Harris, DMD

  • General Practice Dentistry
  • Edgartown, MA
  • NPI 1730205352
  NPD (past)

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1124359773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2135",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "025392135",
            "telephone_number": "508-939-9000",
            "fax_number": "508-939-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 UPPER MAIN ST",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "025395927",
            "telephone_number": "508-939-9000",
            "fax_number": "508-939-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-939-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "19314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua M Levy, RD
• Prudence Levy, R.D.
• Barbara E. Lindley, O.T.R.
• Harold F Lynch, MA
• Deborah Joan Magiera, RPH PHARM D
• Julianne Maxwell, RDN
• Susan Marie McSweeney, NP
• Jacqueline Mary Miller, MSN,ANP-C
• Elizabeth A. Moriarty, NP-C
• Claudette Irene Mullen

• Dentist in Edgartown, MA
• Providers in Edgartown, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.