Active NPI
Elissa Heard, DMD
- General Practice Dentistry
- Quincy, MA
National Provider Identifier
1407917552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13671
- Practice address
- 111 Willard St
1B
Quincy, MA 02169 - Phone
- (617) 471-8640
- Fax
- (617) 471-8640
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13671 | MA | Primary |
Addresses
Primary practice location
111 Willard St
1B
Quincy, MA 02169
Mailing address
111 Willard St
1B
Quincy, MA 02169
Phone (617) 471-8640
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4983 | Other | BCBS | |
| 1131 | Other | DELTA |
Other names 1
- Elissa Rice
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 |
|---|---|---|---|
| 13671 | MA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivana Adamov DDS, PC | General Practice | Past | Accepting new patients |
| Elissa Heard DMD PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Quincy, MA
- NPI 1013060235
-
- General Practice Dentistry
- Quincy, MA
- NPI 1295024073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407917552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 WILLARD ST",
"address_2": "1B",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-471-8640",
"fax_number": "617-471-9328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 WILLARD ST",
"address_2": "1B",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-471-8640",
"fax_number": "617-471-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARD",
"first_name": "ELISSA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "13671",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4983",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA",
"identifier": "1131",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELISSA",
"last_name": "RICE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.