Prichard Family Dental, L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20146 Issued in MA

Legal business name

PRICHARD FAMILY DENTAL, L.L.C.

Practice address

110 Prichard St
Fitchburg, MA 01420-7577

Phone

(978) 343-3031

Fax

(978) 343-3030

NPI assigned

Nov 25, 2015

Organization subpart

No

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

Authorized official

Name

Ahmed El Samra

Title

Owner

Phone

(978) 582-0800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1306210562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PRICHARD ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207577",
            "telephone_number": "978-343-3031",
            "fax_number": "978-343-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PRICHARD ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207577",
            "telephone_number": "978-343-3031",
            "fax_number": "978-343-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRICHARD FAMILY DENTAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "EL SAMRA",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-582-0800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN20146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.