NPIMap

Organization Active NPI

Walter E Gazda Jr DMD PC

  • General Practice Dentistry
  • Chicopee, MA
National Provider Identifier
1275742553
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13284 Issued in MA
Legal business name
WALTER E GAZDA JR DMD PC
Practice address
109 Church Street
Chicopee, MA 01020
Phone
(413) 592-2342
Fax
(413) 592-6608
NPI assigned
May 22, 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
Walter E GazdaNPI 1285741405
Title
Owner
Phone
(413) 592-2342

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
General Practice Dentistry 1223G0001X 13284 MA Primary

Addresses

Primary practice location

109 Church Street
Chicopee, MA 01020

Mailing address

109 Church Street
Chicopee, MA 01020
Phone (413) 592-2342

Other names 1

  • Church Street Dental Other name

National Provider Directory

National Provider Directory

Locations

109 Church St
Chicopee, MA 01020
Phone (413) 592-2342

Practitioners & affiliated clinicians

Practitioners 3

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275742553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CHURCH STREET",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "01020",
            "telephone_number": "413-592-2342",
            "fax_number": "413-592-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CHURCH STREET",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "01020",
            "telephone_number": "413-592-2342",
            "fax_number": "413-592-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER E GAZDA JR DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAZDA",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-592-2342"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Church Street Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicopee, MA

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.