Paul Martin Fitzgerald, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10545 Issued in MA

Practice address

1351 Main St
Brockton, MA 02301

Phone

(508) 587-2000

Fax

(508) 580-3552

NPI assigned

May 23, 2006

Last updated

May 4, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brockton Oral & Maxillofacial Surgery Inc

  • Dentist
  • Brockton, MA
  • NPI 1457370504
  Authorized official Same address or phone

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1275588956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-587-2000",
            "fax_number": "508-580-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-587-2000",
            "fax_number": "508-580-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "PAUL",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "10545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0222321",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Fischer, MA
• Scott Fish, PH.D.
• Jenell Fisher, R.N.
• Fitness Forum Services LLC
• Edward Fitzgerald
• Kimberly Flaherty, DC
• Mary Flaherty, LICSW
• Kathleen Anne Flannery
• James Aloysius Flavin, M.A., M.DIV., LMHC
• Carissa Fleming, OD

• Dentist in Brockton, MA
• Providers in Brockton, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.