Individual provider Active NPI

Eric L Weinstock, DMD

  • Endodontics
  • Canton, MA
National Provider Identifier
1194840058
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
20067 Issued in MA
Practice address
95 Washington St
Suite 482
Canton, MA 02021
Phone
(781) 575-9633
Fax
(781) 575-0086
NPI assigned
Mar 20, 2007
Last updated
Apr 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 20067 MA Primary

Addresses

Primary practice location

95 Washington St
Suite 482
Canton, MA 02021

Mailing address

95 Washington St
Suite 482
Canton, MA 02021
Phone (781) 575-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141027001429 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911128400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20067MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cobb Corner Endodontics PC 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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1194840058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "SUITE 482",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "02021",
            "telephone_number": "781-575-9633",
            "fax_number": "781-575-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "address_2": "SUITE 482",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "02021",
            "telephone_number": "781-575-9633",
            "fax_number": "781-575-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINSTOCK",
        "first_name": "ERIC",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "20067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.