Organization Active NPI

Belmont Oral and Maxillofacial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Belmont, MA
National Provider Identifier
1427811900
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
BELMONT ORAL AND MAXILLOFACIAL SURGERY LLC
Practice address
68 Leonard St Ste 301
Belmont, MA 02478-2574
Phone
(617) 484-5266
Fax
(617) 484-2739
NPI assigned
Feb 6, 2024
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Dr. Pasquale Eckert, DMDNPI 1407384142
Title
Oral Surgeon / Owner
Phone
(617) 484-5266

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) 1223S0112X NU Primary

Addresses

Primary practice location

68 Leonard St Ste 301
Belmont, MA 02478-2574

Mailing address

68 Leonard St Ste 301
Belmont, MA 02478-2574
Phone (617) 484-5266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260417001290 MA Part B Supplier - Clinic/Group Practice 3577039437 Receives reassigned benefits from 2 practitioners
Practice locations: Belmont, MA

National Provider Directory

National Provider Directory

Locations

68 Leonard St
Ste 301
Belmont, MA 02478
Phone (617) 484-5266

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1427811900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 LEONARD ST STE 301",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782574",
            "telephone_number": "617-484-5266",
            "fax_number": "617-484-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 LEONARD ST STE 301",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782574",
            "telephone_number": "617-484-5266",
            "fax_number": "617-484-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMONT ORAL AND MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "ECKERT",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "ORAL SURGEON / OWNER",
        "authorized_official_telephone_number": "617-484-5266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.