NPIMap

Organization Active NPI

Massachusetts Dental Professionals, P.C.

  • General Practice Dentistry
  • Chicopee, MA
National Provider Identifier
1285148494
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MASSACHUSETTS DENTAL PROFESSIONALS, P.C.
Doing business as
Our Dentist of Western Massachusetts
Practice address
747 Memorial Dr
Chicopee, MA 01020-5022
Phone
(413) 217-4455
NPI assigned
Nov 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

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

Authorized official

Name
Cassandra Petersen
Title
Credentialing Team Lead
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

747 Memorial Dr
Chicopee, MA 01020-5022

Mailing address

747 Memorial Dr Unit B
Chicopee, MA 01020-5022
Phone (413) 217-4455

Other names 1

  • Our Dentist of Western Massachusetts Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Massachusetts Dental Professionals PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

747 Memorial Dr
Unit B
Chicopee, MA 01020

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511740800000",
    "number": "1285148494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 MEMORIAL DR UNIT B",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010205022",
            "telephone_number": "413-217-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 MEMORIAL DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010205022",
            "telephone_number": "413-217-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Our Dentist of Western Massachusetts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 27, 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.