Individual provider Active NPI

Alison Hubbard

  • General Practice Dentistry
  • Brockton, MA
National Provider Identifier
1548613573
Registry record updated Jul 14, 2016
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1857316 Issued in MA
Practice address
63 Main St
Brockton, MA 02301-4042
Phone
(508) 559-6699
Fax
(508) 559-5073
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1857316 MA Primary

Addresses

Primary practice location

63 Main St
Brockton, MA 02301-4042

Mailing address

63 Main St
Brockton, MA 02301-4042
Phone (716) 597-6019

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161205001552 MA Order and Referring Only - DentistPractitioner - Dentist 8729368915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1548613573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "716-597-6019",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "ALISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.