NPIMap

Organization Active NPI

Winchester Periodontiocs & Implantology

  • Periodontics
  • Winchester, MA
National Provider Identifier
1235388505
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
20240 Issued in MA
Legal business name
WINCHESTER PERIODONTIOCS & IMPLANTOLOGY
Practice address
955 Main St
Suite 203
Winchester, MA 01890-1961
Phone
(781) 729-9390
Fax
(781) 729-6792
NPI assigned
Sep 11, 2008
Last updated
Sep 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Dr. Robert Mehanna, DMDNPI 1750489431
Title
Owner
Phone
(781) 729-9390

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
Periodontics 1223P0300X 20240 MA Primary

Addresses

Primary practice location

955 Main St
Suite 203
Winchester, MA 01890-1961

Mailing address

955 Main St
Suite 203
Winchester, MA 01890-1961
Phone (781) 729-9390

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": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1235388505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 203",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-729-9390",
            "fax_number": "781-729-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 203",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-729-9390",
            "fax_number": "781-729-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER PERIODONTIOCS & IMPLANTOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "MEHANNA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-729-9390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "20240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.