NPIMap

Organization Active NPI

Hathaway Road Dental, PC

Doing business as Cortland Dental

  • General Practice Dentistry
  • Fall River, MA
National Provider Identifier
1407943954
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HATHAWAY ROAD DENTAL, PC
Doing business as
Cortland Dental
Practice address
933 Pleasant Street
Suite 102-103
Fall River, MA 02723
Phone
(800) 920-9947
Fax
(678) 302-7485
NPI assigned
Oct 6, 2006
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Michelle Jacomino
Title
Director of Payor Relations
Phone
(770) 916-5036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

933 Pleasant Street
Suite 102-103
Fall River, MA 02723

Mailing address

210 Interstate North Pkwy SE Ste 300
Atlanta, GA 30339-2233
Phone (770) 916-9000

Other names 1

  • Cortland Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cortland Dental8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

933 Pleasant St
Ste 102103
Fall River, MA 02723
Phone (508) 673-3044

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1407943954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 INTERSTATE NORTH PKWY SE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392233",
            "telephone_number": "770-916-9000",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 PLEASANT STREET",
            "address_2": "SUITE 102-103",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02723",
            "telephone_number": "800-920-9947",
            "fax_number": "678-302-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATHAWAY ROAD DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "JACOMINO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "770-916-5036"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cortland Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.