Active NPI
Thomas J Allen Jr., DMD
- General Practice Dentistry
- Holden, MA
National Provider Identifier
1154495364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15842
- Practice address
- 1010 Main Street
Suite 6
Holden, MA 01520 - Phone
- (508) 829-3292
- Fax
- (508) 829-9323
- NPI assigned
- Nov 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15842 | MA | Primary |
| General Practice Dentistry | 1223G0001X | DS026162L | PA |
Addresses
Primary practice location
1010 Main Street
Suite 6
Holden, MA 01520
Mailing address
1010 Main Street
Suite 6
Holden, MA 01520
Phone (508) 829-3292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151030000873 | MA | Order and Referring Only - Dentist | 0941510176 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15842 | MA | MD | General Practice Dentistry |
| DS026162L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandy Lor DMD LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154495364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 MAIN STREET",
"address_2": "SUITE 6",
"city": "HOLDEN",
"state": "MA",
"postal_code": "01520",
"telephone_number": "508-829-3292",
"fax_number": "508-829-9323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 MAIN STREET",
"address_2": "SUITE 6",
"city": "HOLDEN",
"state": "MA",
"postal_code": "01520",
"telephone_number": "508-829-3292",
"fax_number": "508-829-9323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "THOMAS",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "15842",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS026162L",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.