Eric Matthew Block, DMD, CAGS
Individual provider Active NPI Dentist · Acton, MA
NPI 1164511887 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164511887
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 20898 (MA)
- Practice address
- 179 Great Rd
Suite #204
Acton, MA 01720-5777 - Phone
- (978) 263-3526
- Fax
- (978) 263-5558
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150805007215 | MA | Order and Referring Only - Dentist |
8820302748 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20898 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acton Dental Associates, P.C. | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20898 | MA | Yes |
Addresses
Primary practice location
179 Great Rd
Suite #204
Acton, MA 01720-5777
Mailing address
1080 Beacon St Apt 1D
Brookline, MA 02446-3916
Phone (617) 216-7937
Other providers in Acton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.