NPIMap

Organization Active NPI

Western Mass Periodontics, LLC

  • Periodontics
  • Wilbraham, MA
National Provider Identifier
1548596398
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
20600 Issued in MA
Legal business name
WESTERN MASS PERIODONTICS, LLC
Practice address
85 Post Office Park
Suite 8503
Wilbraham, MA 01095-1247
Phone
(413) 596-0009
Fax
(413) 596-0199
NPI assigned
Oct 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Authorized official

Name
Dr. Norman E Lee, DMD
Title
Manager
Phone
(413) 596-0009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 20600 MA Primary

Addresses

Primary practice location

85 Post Office Park
Suite 8503
Wilbraham, MA 01095-1247

Mailing address

85 Post Office Park
Suite 8503
Wilbraham, MA 01095-1247
Phone (413) 596-0009

National Provider Directory

National Provider Directory

Locations

85 Post Office Park
Ste 8503
Wilbraham, MA 01095
Phone (413) 596-0009

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1548596398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 POST OFFICE PARK",
            "address_2": "SUITE 8503",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951247",
            "telephone_number": "413-596-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 POST OFFICE PARK",
            "address_2": "SUITE 8503",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "010951247",
            "telephone_number": "413-596-0009",
            "fax_number": "413-596-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MASS PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-29",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "413-596-0009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "20600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilbraham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.