Emessa Dental Associates,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19475 Issued in MA

Legal business name

EMESSA DENTAL ASSOCIATES,P.C.

Practice address

95 Washington St
Suite 472
Canton, MA 02021-4006

Phone

(781) 828-2600

Fax

(781) 828-2619

NPI assigned

Jul 18, 2012

Last updated

Jul 18, 2012By 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. Zaki Michael Mukdissi, DMDNPI 1023122637

Title

Owner/President

Phone

(781) 828-2600

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.

• Zaki Michael Mukdissi, DMD

  • General Practice Dentistry
  • Canton, MA
  • NPI 1023122637
  NPD (past) Authorized official

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1144575861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "SUITE 472",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-828-2600",
            "fax_number": "781-828-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "SUITE 472",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-828-2600",
            "fax_number": "781-828-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMESSA DENTAL ASSOCIATES,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "MUKDISSI",
        "authorized_official_first_name": "ZAKI",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "781-828-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Eddy Muccilli, PSY.D.
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• Christine Lynne Derosier Erikson, M.E.D.
• Sarah Ervin, MS,OTR/L

• General Practice Dentistry in Canton, MA
• Providers in Canton, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.