Edgartown Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EDGARTOWN DENTAL GROUP LLC

Practice address

207 Upper Main St
Edgartown, MA 02539-5927

Phone

(508) 939-9000

NPI assigned

Aug 30, 2017

Last updated

Aug 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bari Stern

Title

Admin Coordinator

Phone

(917) 696-4515

Specialties & licenses 1

Addresses

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.

• Glenn R Harris, DMD

  • General Practice Dentistry
  • Edgartown, MA
  • NPI 1730205352
  NPD (past)

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1235657255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9000",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "025399000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 UPPER MAIN ST",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "025395927",
            "telephone_number": "508-939-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGARTOWN DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "BARI",
        "authorized_official_title_or_position": "ADMIN COORDINATOR",
        "authorized_official_telephone_number": "917-696-4515"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Ryan Delprete, PHARMD, RPH
• Jenna A Delsapio, NP
• Marcia L Denine, NP
• Michael Ditchfield, MSW.,LICSW
• Dukes County Sheriff's Office
• Rhonda L Fauteux, A.B.O.C.
• Molly Bonner Flam
• Francine Agnoli (Silver Rose Designs)
• Carol Lynn Goldstein, MD
• Eric Myles Gordon, PT

• General Practice Dentistry in Edgartown, MA
• Providers in Edgartown, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.