NPIMap

Organization Active NPI

Pleasant Valley Dental Health, PC

  • General Practice Dentistry
  • Methuen, MA
National Provider Identifier
1164433215
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14747 Issued in MA
Legal business name
PLEASANT VALLEY DENTAL HEALTH, PC
Practice address
380 Merrimack St
Suite 3E
Methuen, MA 01844-5870
Phone
(978) 685-2511
Fax
(978) 683-3985
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Authorized official

Name
Gary Henry Wainwright, DMDNPI 1669525085
Title
President
Phone
(978) 685-2511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14747 MA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 19703 MA

Addresses

Primary practice location

380 Merrimack St
Suite 3E
Methuen, MA 01844-5870

Mailing address

380 Merrimack St
Suite 3E
Methuen, MA 01844-5870
Phone (978) 685-2511

Other identifiers 2

IdentifierTypeStateIssuer
0200671MedicaidMA
9783547MedicaidMA

National Provider Directory

National Provider Directory

Locations

380 Merrimack St
Ste 3E
Methuen, MA 01844
Phone (978) 685-2511

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1164433215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 3E",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-685-2511",
            "fax_number": "978-683-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 3E",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-685-2511",
            "fax_number": "978-683-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY DENTAL HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "WAINWRIGHT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-685-2511",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14747",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200671",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9783547",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.