NPIMap

Organization Active NPI

Creative Smiles Dental Care, PLLC

  • Dentist
  • Brockton, MA
National Provider Identifier
1225441819
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856486 Issued in MA
Legal business name
CREATIVE SMILES DENTAL CARE, PLLC
Practice address
907 Main St
Brockton, MA 02301-6629
Phone
(630) 456-6334
NPI assigned
Jun 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Authorized official

Name
Mrugank M Sardhara, DDSNPI 1194089821
Title
Manager
Phone
(630) 456-6334

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 DN1856486 MA Primary

Addresses

Primary practice location

907 Main St
Brockton, MA 02301-6629

Mailing address

800 Pleasant St Apt 809
New Bedford, MA 02740-6128
Phone (630) 456-6334

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1225441819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PLEASANT ST APT 809",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027406128",
            "telephone_number": "630-456-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016629",
            "telephone_number": "630-456-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE SMILES DENTAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "SARDHARA",
        "authorized_official_first_name": "MRUGANK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-456-6334",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.