Individual provider Active NPI

Eileen Marie Saunders, D.M.D

  • Dentist
  • Brockton, MA
National Provider Identifier
1295004083
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855811 Issued in MA
Practice address
4 Main St
Brockton, MA 02301-4027
Phone
(508) 587-7775
NPI assigned
Dec 22, 2011
Last updated
Dec 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1855811 MA Primary

Addresses

Primary practice location

4 Main St
Brockton, MA 02301-4027

Mailing address

4 Main St
Brockton, MA 02301-4027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160105002587 NH Practitioner - Maxillofacial Surgery 4880996008 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855811MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 24, 2015 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 24, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 24, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 24, 2015 Accepting new patients
Brockton Family Dental Inc. Dentist Past Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: esaunders180785@direct.dartmouth-hitchcock.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1295004083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014027",
            "telephone_number": "508-587-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "EILEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.