Super Dental of Fitchburg PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUPER DENTAL OF FITCHBURG PLLC

Practice address

130 Water St
Fitchburg, MA 01420-5478

Phone

(978) 342-8500

NPI assigned

Oct 16, 2020

Last updated

Oct 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Houssam Alkhoury

Title

Owner

Phone

(508) 589-8270

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1386242758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 ELM ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481638",
            "telephone_number": "508-589-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205478",
            "telephone_number": "978-342-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER DENTAL OF FITCHBURG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "ALKHOURY",
        "authorized_official_first_name": "HOUSSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-589-8270"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Sturgis, NP
• Barbara G. Sullivan, NP
• Iris Sullivan, MD
• Susan Sullivan
• Nicole Danielle Summers-Dubois, MS, LMFT
• Rhonda Marie Surette, NP
• Hector Ivan Surillo
• Sarah Marie Survell
• Richard George Suval, D.M.D
• Asuka Suzuki, RD

• Dental Clinic/Center in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.