NPIMap

Organization Active NPI

Cornerstone Kids Dentistry

  • Pediatric Dentistry
  • Agawam, MA
National Provider Identifier
1568813293
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN1857118 Issued in MA
Legal business name
CORNERSTONE KIDS DENTISTRY
Practice address
332 Suffield Sreet
Agawam, MA 01001
Phone
(413) 786-0077
NPI assigned
Jun 23, 2016
Last updated
Jun 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Ms. Jennifer Lynn Sady
Title
Office Manager
Phone
(413) 786-0077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN1857118 MA Primary

Addresses

Primary practice location

332 Suffield Sreet
Agawam, MA 01001

Mailing address

332 Suffield Sreet
Agawam, MA 01001
Phone (413) 786-0077

National Provider Directory

National Provider Directory

Locations

332 Suffield St
Agawam, MA 01001
Phone (413) 786-0077

Practitioners & affiliated clinicians

Practitioners 3

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": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1568813293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 SUFFIELD SREET",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "01001",
            "telephone_number": "413-786-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 SUFFIELD SREET",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "01001",
            "telephone_number": "413-786-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE KIDS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "SADY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "413-786-0077",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1857118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.