Active NPI
Paul A Larocque, DMD
- General Practice Dentistry
- Orange, MA
National Provider Identifier
1316024813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9674
- Practice address
- 450 W River St
Suite 2
Orange, MA 01364-1435 - Phone
- (978) 544-7965
- Fax
- (978) 544-2922
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9674 | MA | Primary |
Addresses
Primary practice location
450 W River St
Suite 2
Orange, MA 01364-1435
Mailing address
450 W River St
Suite 2
Orange, MA 01364-1435
Phone (978) 544-7965
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150818003735 | MA | Order and Referring Only - Dentist | 0042525255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9674 | MA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316024813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 W RIVER ST",
"address_2": "SUITE 2",
"city": "ORANGE",
"state": "MA",
"postal_code": "013641435",
"telephone_number": "978-544-7965",
"fax_number": "978-544-2922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W RIVER ST",
"address_2": "SUITE 2",
"city": "ORANGE",
"state": "MA",
"postal_code": "013641435",
"telephone_number": "978-544-7965",
"fax_number": "978-544-2922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROCQUE",
"first_name": "PAUL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "9674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.