Hershel T Ellenbogen, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19110 Issued in MA

Practice address

98 Church St
Whitinsville, MA 01588-1416

Phone

(508) 234-5073

NPI assigned

Jun 23, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558367557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 CHURCH ST",
            "city": "WHITINSVILLE",
            "state": "MA",
            "postal_code": "015881416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 CHURCH ST",
            "city": "WHITINSVILLE",
            "state": "MA",
            "postal_code": "015881416",
            "telephone_number": "508-234-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "HERSHEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "X11549",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justine Doyon, FNP-C
• Dr James Pialtos Optometrist (Eye Associates)
• Jillian Drummond
• John Francis Duffy
• Barbara Georgina East, M.SC CLINICIAN
• Kathleen Faron, DS
• Reba Ann Fennessey
• Melissa Leigh Fijol
• Barbara Ann Filipe
• Paula Flaherty Bolotin

• General Practice Dentistry in Whitinsville, MA
• Providers in Whitinsville, MA by specialty
• General Practice Dentistry 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.