Nicholas Peter Theberge, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DN1857508 Issued in MA

Practice address

285 High St
Greenfield, MA 01301-2608

Phone

(413) 774-2961

Fax

(413) 773-3076

NPI assigned

Feb 19, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT, MA, NH3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connecticut Valley Oral Surgery Associates, PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Brattleboro, VT
  • NPI 1912928946

  Oral & Maxillofacial Surgery, VT

  Medicare reassignment NPD
• Connecticut Valley Oral Surgery Associates, PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Greenfield, MA
  • NPI 1285655217

  MA

  Medicare reassignment
• Connecticut Valley Oral Surgery Associates, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Keene, NH
  • NPI 1417328162

  NH

  Medicare reassignment
• Monadnock Oral and Maxillofacial Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Keene, NH
  • NPI 1477754810
  NPD (past)

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1346580974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 WHITE BIRCH DR",
            "city": "CHESTERFIELD",
            "state": "NH",
            "postal_code": "034433622",
            "telephone_number": "603-903-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 HIGH ST",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013012608",
            "telephone_number": "413-774-2961",
            "fax_number": "413-773-3076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "272 Main St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034314122",
            "country_code": "US",
            "telephone_number": "603-357-3709",
            "fax_number": "603-357-3709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "368 Canal St",
            "address_purpose": "LOCATION",
            "city": "Brattleboro",
            "state": "VT",
            "postal_code": "053016618",
            "country_code": "US",
            "telephone_number": "802-254-9418",
            "fax_number": "802-254-9418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEBERGE",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-19",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1857508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nuk Thann, BA LEGAL STUDIES
• The Commonwealth of Massachusetts
• The Community Young Men'S Christian Association of Greenfield, Mass
• The Stop & Shop Supermarket Company, LLC
• The United Arc of Franklin & Hampshire Co
• Kelly Thibodeau
• Sandra A Thomaier, NP, CNS
• Franklin R Thomas, M.D.
• Jonathan Thomas, LICSW
• Rene Michelle Thomas, OT

• All providers in Greenfield, MA
• Oral & Maxillofacial Surgery (D.M.D.) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.

Verify at the official NPI Registry.