Organization Active NPI

Ralph P. Ergas DMD Lynnette Nyberg DMD MSD PA

  • Pediatric Dentistry
  • Manchester, NH
National Provider Identifier
1255548806
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2545 Issued in NH
Legal business name
RALPH P. ERGAS DMD LYNNETTE NYBERG DMD MSD PA
Practice address
1100 Bicentennial Dr
Manchester, NH 03104-2140
Phone
(603) 622-7500
Fax
(603) 622-5648
NPI assigned
May 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ralph Peter Ergas, DMD
Title
Owner
Phone
(603) 622-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2545 NH Primary

Addresses

Primary practice location

1100 Bicentennial Dr
Manchester, NH 03104-2140

Mailing address

1100 Bicentennial Dr
Manchester, NH 03104-2140
Phone (603) 622-7500

Other identifiers 1

IdentifierTypeStateIssuer
30304944MedicaidNH

National Provider Directory

National Provider Directory

Locations

1100 Bicentennial Dr
Manchester, NH 03104
Phone (603) 622-7500

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255548806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BICENTENNIAL DR",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042140",
            "telephone_number": "603-622-7500",
            "fax_number": "603-622-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BICENTENNIAL DR",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042140",
            "telephone_number": "603-622-7500",
            "fax_number": "603-622-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH P. ERGAS DMD LYNNETTE NYBERG DMD MSD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERGAS",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-622-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NH",
            "license": "2545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30304944",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.