NPIMap

Organization Active NPI

Monica a Gobran DMD PC

  • General Practice Dentistry
  • Worcester, MA
National Provider Identifier
1386757458
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21325 Issued in MA
Legal business name
MONICA A GOBRAN DMD PC
Practice address
11 Harvard St
Worcester, MA 01609-2839
Phone
(508) 753-3200
Fax
(508) 753-1894
NPI assigned
Aug 16, 2006
Last updated
Oct 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Dr. Monica Ayoub Gobran, DMDNPI 1679688097
Title
President
Phone
(508) 753-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 21325 MA Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

11 Harvard St
Worcester, MA 01609-2839

Mailing address

11 Harvard St
Worcester, MA 01609-2839
Phone (508) 753-3200

Other names 1

  • Monica A Gobran, DMD PC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707002251 MA DME Supplier - Physician - General Practice 4183940208 Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

11 Harvard St
Worcester, MA 01609
Phone (508) 753-3200

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1386757458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092839",
            "telephone_number": "508-753-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092839",
            "telephone_number": "508-753-3200",
            "fax_number": "508-753-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONICA A GOBRAN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "GOBRAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "AYOUB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-753-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21325",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monica A Gobran, DMD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Monica A Gobran, DMD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.