NPIMap

Organization Active NPI

Mansfield Periodontics and Dental Implants, PLLC

  • Dental Clinic/Center
  • Mansfield, MA
National Provider Identifier
1194260588
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
21803 Issued in MA
Legal business name
MANSFIELD PERIODONTICS AND DENTAL IMPLANTS, PLLC
Practice address
100 Copeland Dr
Unit 3
Mansfield, MA 02048-1245
Phone
(508) 543-9292
Fax
(508) 339-1919
NPI assigned
Dec 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Dr. Valerie Anne Smith, DMDNPI 1457354425
Title
President
Phone
(508) 543-9292

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
Dental Clinic/Center 261QD0000X 21803 MA Primary

Addresses

Primary practice location

100 Copeland Dr
Unit 3
Mansfield, MA 02048-1245

Mailing address

100 Copeland Dr
Unit 3
Mansfield, MA 02048-1245
Phone (508) 543-9292

National Provider Directory

National Provider Directory

Locations

100 Copeland Dr
Ste 3
Mansfield, MA 02048
Phone (508) 543-9292

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": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1194260588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COPELAND DR",
            "address_2": "UNIT 3",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481245",
            "telephone_number": "508-543-9292",
            "fax_number": "508-339-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COPELAND DR",
            "address_2": "UNIT 3",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481245",
            "telephone_number": "508-543-9292",
            "fax_number": "508-339-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD PERIODONTICS AND DENTAL IMPLANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-543-9292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "21803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.