Joseph G Gomez Jr., DMD – Dentist in Orange, MA

Key facts

NPI: 1164617445
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 13739 (MA)
Practice address: 450 W River St
Suite 2
Orange, MA 01364-1435
Phone: (978) 544-7965
Fax: (978) 544-2922
NPI assigned: Sep 11, 2007
Sex: Male
Sole proprietor: No

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
I20141118000059	MA	Order and Referring Only - Oral Surgery Practitioner - Oral Surgery	1658593108

National Provider Directory

Medicare enrollment (NPD): Yes

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	13739	MA	Yes

Addresses

Primary practice location

450 W River St
Suite 2
Orange, MA 01364-1435

Mailing address

450 W River St
Suite 2
Orange, MA 01364-1435
Phone (978) 544-7965

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2007.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1164617445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W RIVER ST",
            "address_2": "SUITE 2",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "013641435",
            "telephone_number": "978-544-7965",
            "fax_number": "978-544-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W RIVER ST",
            "address_2": "SUITE 2",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "013641435",
            "telephone_number": "978-544-7965",
            "fax_number": "978-544-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "13739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, MA

All providers in Orange, MA · Dentist in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.