Active NPI
Matthew Devine, D.M.D.
- Dentist
- Randolph, MA
National Provider Identifier
1366898413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1857545
- Practice address
- 1395 N Main St
Randolph, MA 02368-1768 - Phone
- (781) 963-6077
- NPI assigned
- May 9, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN1857545 | MA | Primary |
Addresses
Primary practice location
1395 N Main St
Randolph, MA 02368-1768
Mailing address
56 Barton Street
#3
Providence, RI 02909
Phone (617) 599-9747
Other practice location 1
380 South St
Jamaica Plain, MA 02130-3511
Phone (617) 599-9747
Other practice location 2
101 Pleasant St Ste 210
Worcester, MA 01609-3213
Phone (774) 420-2600
Other practice location 3
126 Union St Ofc 3
Marlborough, MA 01752-1207
Phone (508) 481-4200
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 |
|---|---|---|---|
| DN1857545 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1366898413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 BARTON STREET",
"address_2": "#3",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02909",
"telephone_number": "617-599-9747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1395 N MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023681768",
"telephone_number": "781-963-6077"
}
],
"practiceLocations": [
{
"address_1": "380 South St",
"address_purpose": "LOCATION",
"city": "Jamaica Plain",
"state": "MA",
"postal_code": "021303511",
"country_code": "US",
"telephone_number": "617-599-9747",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 Pleasant St Ste 210",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016093213",
"country_code": "US",
"telephone_number": "774-420-2600",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "126 Union St Ofc 3",
"address_purpose": "LOCATION",
"city": "Marlborough",
"state": "MA",
"postal_code": "017521207",
"country_code": "US",
"telephone_number": "508-481-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEVINE",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-09",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1857545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.