Active NPI
64 Highland Dental
- General Practice Dentistry
- Worcester, MA
National Provider Identifier
1508195140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- 64 HIGHLAND DENTAL
- Practice address
- 64 Highland Street
Worcester, MA 01609 - Phone
- (508) 926-8660
- Fax
- (508) 426-8667
- NPI assigned
- Dec 10, 2009
- Last updated
- May 11, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Miller, DDS
- Title
- Owner
- Phone
- (508) 926-8660
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | |||
| General Practice Dentistry | 1223G0001X | 20028 | MA | |
| General Practice Dentistry | 1223G0001X | Primary | ||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | |||
| Dental Hygienist | 124Q00000X |
Addresses
Primary practice location
64 Highland Street
Worcester, MA 01609
Mailing address
64 Highland Street
Worcester, MA 01609
Phone (508) 926-8660
National Provider Directory
National Provider DirectoryLocations
64 Highland St
Worcester, MA 01609
Phone (508) 926-8660
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Endodontics
- Worcester, MA
- NPI 1003277096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431302400000",
"number": "1508195140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 HIGHLAND STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01609",
"telephone_number": "508-926-8660",
"fax_number": "508-926-8667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 HIGHLAND STREET",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01609",
"telephone_number": "508-926-8660",
"fax_number": "508-426-8667"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "64 HIGHLAND DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-10",
"last_updated": "2015-05-11",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "508-926-8660",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "20028",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": null,
"license": null,
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.