Individual provider Active NPI

Sean O'Brien, D.M.D

  • General Practice Dentistry
  • Duxbury, MA
National Provider Identifier
1316324759
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1857220 Issued in MA
Practice address
104 Tremont St Ste 4
Duxbury, MA 02332-4750
Phone
(781) 934-5292
NPI assigned
May 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1857220 MA Primary

Addresses

Primary practice location

104 Tremont St Ste 4
Duxbury, MA 02332-4750

Mailing address

104 Tremont St Ste 4
Duxbury, MA 02332-4750
Phone (781) 934-5292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160407001576 CT Order and Referring Only - DentistPractitioner - Dentist 5092013037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1857220MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1316324759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 TREMONT ST STE 4",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324750",
            "telephone_number": "781-934-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TREMONT ST STE 4",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324750",
            "telephone_number": "781-934-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duxbury, MA

Sources for this page

Verify at the official NPI Registry.