Restorative Dental Group of Metro West

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

19478 Issued in MA

Legal business name

RESTORATIVE DENTAL GROUP OF METRO WEST

Practice address

67 Union St
Suite 104 Medical Building
Natick, MA 01760-7700

Phone

(508) 650-7641

NPI assigned

Jun 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gijsbertus Brandse, D.M.D.

Title

Dentist

Phone

(508) 650-7641

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1265692644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 UNION ST",
            "address_2": "SUITE 104 MEDICAL BUILDING",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-650-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 UNION ST",
            "address_2": "SUITE 104 MEDICAL BUILDING",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-650-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE DENTAL GROUP OF METRO WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BRANDSE",
        "authorized_official_first_name": "GIJSBERTUS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "508-650-7641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "19478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Natick, MA
• Providers in Natick, MA by specialty
• Prosthodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.