NPIMap

Organization Active NPI

Mansfield Family Dental, LLC

  • General Practice Dentistry
  • Mansfield, MA
National Provider Identifier
1538623913
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANSFIELD FAMILY DENTAL, LLC
Practice address
235 Central St
Mansfield, MA 02048-1341
Phone
(508) 339-3766
Fax
(508) 339-3763
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Authorized official

Name
Mardy Costa
Title
Administrator
Phone
(508) 728-5019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

235 Central St
Mansfield, MA 02048-1341

Mailing address

235 Central St
Mansfield, MA 02048-1341
Phone (508) 339-3766

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1538623913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CENTRAL ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481341",
            "telephone_number": "508-339-3766",
            "fax_number": "508-339-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CENTRAL ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481341",
            "telephone_number": "508-339-3766",
            "fax_number": "508-339-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "MARDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "508-728-5019"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.