NPIMap

Organization Active NPI

Chicopee Family Dental, LLC

  • Dentist
  • Chicopee, MA
National Provider Identifier
1417350158
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19743 Issued in MA
Legal business name
CHICOPEE FAMILY DENTAL, LLC
Practice address
30 Saint James Ave
Chicopee, MA 01020-2453
Phone
(413) 592-2177
Fax
(413) 592-3278
NPI assigned
Oct 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Authorized official

Name
Michelle M Cormier
Title
Office Manager
Phone
(413) 592-2177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19743 MA Primary

Addresses

Primary practice location

30 Saint James Ave
Chicopee, MA 01020-2453

Mailing address

30 Saint James Ave
Chicopee, MA 01020-2453
Phone (413) 592-2177

National Provider Directory

National Provider Directory

Locations

30 Saint James Ave
Chicopee, MA 01020
Phone (413) 592-2177

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1417350158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SAINT JAMES AVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010202453",
            "telephone_number": "413-592-2177",
            "fax_number": "413-592-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SAINT JAMES AVE",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010202453",
            "telephone_number": "413-592-2177",
            "fax_number": "413-592-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICOPEE FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "CORMIER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "413-592-2177"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "19743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.