Herbert Irving Bader, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

9924 Issued in MA

Practice address

110 Long Pond Rd Ste 204
Plymouth, MA 02360-2642

Phone

(508) 830-3339

Fax

(508) 830-1976

NPI assigned

Jan 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sandra L Macdonald DMD PC

  • Dentist
  • Plymouth, MA
  • NPI 1851413728
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487790507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 JAMES CIR",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026494913",
            "telephone_number": "508-830-3339",
            "fax_number": "508-830-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 204",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-830-3339",
            "fax_number": "508-830-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "HERBERT",
        "middle_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayanna Freedom Inc.
• Katherine Jane Ayers, M.D.
• Savannah Aylward
• Amy Lyn Azevedo
• B-XII Plymouth LLC (Benchmark Senior Living at Plymouth Crossings)
• Yoonji Baek
• Ruth Bailey, B.S
• Benjamin Baird
• Debra Baker, MA, LMHC
• Jamie Lynn Baker, MA, MRC

• Periodontics in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Periodontics in Massachusetts

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.