NPIMap

Organization Active NPI

McNally Brothers

  • Oral and Maxillofacial Surgery (Dentist)
  • West Springfield, MA
National Provider Identifier
1396897823
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MCNALLY BROTHERS
Practice address
75 Van Deene Ave
Suite 201
West Springfield, MA 01089
Phone
(413) 788-9621
Fax
(413) 788-0103
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Mr. Christopher R Desesa, DMDNPI 1154617686
Title
President
Phone
(413) 788-9621

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

75 Van Deene Ave
Suite 201
West Springfield, MA 01089

Mailing address

75 Van Deene Ave
Suite 201
West Springfield, MA 01089-3213
Phone (413) 788-9621

Other names 1

  • McNally Brothers DMD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070405000042 MA Part B Supplier - Clinic/Group Practice 9234233966 Receives reassigned benefits from 5 practitioners
Practice locations: West Springfield, MA
O20170214000494 CT Part B Supplier - Clinic/Group Practice 9234233966 Receives reassigned benefits from 5 practitioners
Practice locations: Enfield, CT

National Provider Directory

National Provider Directory

Locations

115 Elm St
Ste 209
Enfield, CT 06082
Phone (860) 641-2277

75 Van Deene Ave
West Springfield, MA 01089
Phone (413) 734-0416

75 Van Deene Ave
Ste 201
West Springfield, MA 01089
Phone (413) 788-9621

74 Court St
Westfield, MA 01085
Phone (413) 562-9687

Practitioners & affiliated clinicians

Practitioners 9

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1396897823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VAN DEENE AVE",
            "address_2": "SUITE 201",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893213",
            "telephone_number": "413-788-9621",
            "fax_number": "413-788-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VAN DEENE AVE",
            "address_2": "SUITE 201",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-788-9621",
            "fax_number": "413-788-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCNALLY BROTHERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "DESESA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-788-9621",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McNally Brothers DMD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "McNally Brothers DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.