NPIMap

Organization Active NPI

41 State Rd, LLC

  • Periodontics
  • North Dartmouth, MA
National Provider Identifier
1144701020
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN1856413 Issued in MA
Legal business name
41 STATE RD, LLC
Practice address
1379 Tucker Road
North Dartmouth, MA 02747
Phone
(508) 993-9105
Fax
(508) 993-9115
NPI assigned
Aug 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Mahmoud Hamad, DMD
Title
Periodontist/Owner
Phone
(508) 993-9105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DN1856413 MA Primary

Addresses

Primary practice location

1379 Tucker Road
North Dartmouth, MA 02747

Mailing address

1379 Tucker Road
North Dartmouth, MA 02747
Phone (508) 993-9105

Other names 1

  • Dartmouth Periodontics and Implant Dentistry Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1144701020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 TUCKER ROAD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-993-9105",
            "fax_number": "508-993-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 TUCKER ROAD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "02747",
            "telephone_number": "508-993-9105",
            "fax_number": "508-993-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "41 STATE RD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "HAMAD",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "508-993-9105",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1856413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dartmouth Periodontics and Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.