Individual provider Active NPI

Philip A Struzziero, DMD

  • Dentist
  • Braintree, MA
National Provider Identifier
1174604086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN129181 Issued in MA
Practice address
575 Washington St
Suite 152
Braintree, MA 02184-5620
Phone
(781) 356-8111
Fax
(781) 356-9036
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN129181 MA Primary

Addresses

Primary practice location

575 Washington St
Suite 152
Braintree, MA 02184-5620

Mailing address

575 Washington St
Suite 152
Braintree, MA 02184-5620
Phone (781) 356-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN129181MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Philip a Struzziero Dentist 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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174604086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 WASHINGTON ST",
            "address_2": "SUITE 152",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845620",
            "telephone_number": "781-356-8111",
            "fax_number": "781-356-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 WASHINGTON ST",
            "address_2": "SUITE 152",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845620",
            "telephone_number": "781-356-8111",
            "fax_number": "781-356-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUZZIERO",
        "first_name": "PHILIP",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN129181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.