Active NPI
Siri Steinle, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Brockton, MA
National Provider Identifier
1316118458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 17979
- Practice address
- 1058 N Main St
Brockton, MA 02301-1534 - Phone
- (508) 583-3171
- Fax
- (508) 583-3180
- NPI assigned
- Mar 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 17979 | MA | Primary |
Addresses
Primary practice location
1058 N Main St
Brockton, MA 02301-1534
Mailing address
1058 N Main St
Brockton, MA 02301-1534
Phone (508) 583-3171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0276197 | Medicaid | MA | |
| V05042 | Other | MA | DENTAL BLUE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17979 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siri C Steinle DMD PC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Brockton, MA
- NPI 1780794347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1316118458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1058 N MAIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011534",
"telephone_number": "508-583-3171",
"fax_number": "508-583-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1058 N MAIN ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011534",
"telephone_number": "508-583-3171",
"fax_number": "508-583-3180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEINLE",
"first_name": "SIRI",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MA",
"license": "17979",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0276197",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BLUE",
"identifier": "V05042",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.