Active NPI
Michael H Wasserman, DDS
- General Practice Dentistry
- Pittsfield, MA
National Provider Identifier
1477555639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15581
- Practice address
- 54 Wendell Ave
Pittsfield, MA 01201-6312 - Phone
- (413) 442-2052
- Fax
- (413) 442-2052
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 15581 | MA | Primary |
Addresses
Primary practice location
54 Wendell Ave
Pittsfield, MA 01201-6312
Mailing address
54 Wendell Ave
Pittsfield, MA 01201-6312
Phone (413) 442-2052
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15581 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1477555639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 WENDELL AVE",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012016312",
"telephone_number": "413-442-2052",
"fax_number": "413-442-2052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 WENDELL AVE",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012016312",
"telephone_number": "413-442-2052",
"fax_number": "413-442-2052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "MICHAEL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "15581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.