NPIMap

Organization Active NPI

Full Service Dental Health P.C.

  • General Practice Dentistry
  • Brockton, MA
National Provider Identifier
1568512655
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20001 Issued in MA
Legal business name
FULL SERVICE DENTAL HEALTH P.C.
Practice address
200 Westgate Dr Ste 2
Brockton, MA 02301-1810
Phone
(508) 587-5333
Fax
(508) 584-5017
NPI assigned
Jan 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Raffi Merjik, D.M.D
Title
Owner Dentist
Phone
(508) 587-5333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20001 MA Primary

Addresses

Primary practice location

200 Westgate Dr Ste 2
Brockton, MA 02301-1810

Mailing address

200 Westgate Dr Ste 2
Brockton, MA 02301-1810
Phone (508) 587-5333

National Provider Directory

National Provider Directory

Locations

200 Westgate Dr
Ste 2
Brockton, MA 02301
Phone (508) 587-5333

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568512655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WESTGATE DR STE 2",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011810",
            "telephone_number": "508-587-5333",
            "fax_number": "508-584-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WESTGATE DR STE 2",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011810",
            "telephone_number": "508-587-5333",
            "fax_number": "508-584-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SERVICE DENTAL HEALTH P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MERJIK",
        "authorized_official_first_name": "RAFFI",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "508-587-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.