NPIMap

Organization Active NPI

Baystate Family Dental

  • Dentist
  • Worcester, MA
National Provider Identifier
1184849986
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19194 Issued in MA
Legal business name
BAYSTATE FAMILY DENTAL
Practice address
9 Halmstad St
Worcester, MA 01607-1519
Phone
(508) 792-6807
Fax
(508) 792-6804
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Sami E Nassar, DDSNPI 1609034750
Title
President
Phone
(508) 792-6807

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19194 MA Primary

Addresses

Primary practice location

9 Halmstad St
Worcester, MA 01607-1519

Mailing address

9 Halmstad St
Worcester, MA 01607-1519
Phone (508) 792-6807

Other identifiers 1

IdentifierTypeStateIssuer
250859743MedicaidMA

National Provider Directory

National Provider Directory

Locations

9 Halmstad St
Worcester, MA 01607
Phone (508) 792-6807

Practitioners & affiliated clinicians

Practitioners 1

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1184849986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HALMSTAD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071519",
            "telephone_number": "508-792-6807",
            "fax_number": "508-792-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HALMSTAD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016071519",
            "telephone_number": "508-792-6807",
            "fax_number": "508-792-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSTATE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "NASSAR",
        "authorized_official_first_name": "SAMI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-792-6807",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "19194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250859743",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.