NPIMap

Organization Active NPI

Infante & Gomez PC

  • Prosthodontics
  • Sudbury, MA
National Provider Identifier
1396025441
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN21117 Issued in MA
Legal business name
INFANTE & GOMEZ PC
Practice address
29 Hudson Rd
3220
Sudbury, MA 01776-1747
Phone
(978) 443-4545
NPI assigned
Aug 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Dr. Gustavo J Infante, DMDNPI 1942414263
Title
P
Phone
(617) 645-3286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN21546 MA
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X DN21117 MA Primary

Addresses

Primary practice location

29 Hudson Rd
3220
Sudbury, MA 01776-1747

Mailing address

29 Hudson Rd
3220
Sudbury, MA 01776-1747
Phone (978) 443-4545

Other identifiers 2

IdentifierTypeStateIssuer
1124249826MedicaidMA
1942414263MedicaidMA

Other names 1

  • GLAD Specialized Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

29 Hudson Rd
Ste 3220
Sudbury, MA 01776
Phone (617) 645-3286

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1396025441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HUDSON RD",
            "address_2": "3220",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761747",
            "telephone_number": "978-443-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HUDSON RD",
            "address_2": "3220",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761747",
            "telephone_number": "978-443-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFANTE & GOMEZ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "INFANTE",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "P",
        "authorized_official_telephone_number": "617-645-3286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN21546",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "DN21117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124249826",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942414263",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLAD Specialized Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sudbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.