Southeastern Dental Care, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21958 Issued in MA

Legal business name

SOUTHEASTERN DENTAL CARE, PC

Practice address

336 Bedford St
Lakeville, MA 02347-2136

Phone

(508) 947-5717

Fax

(508) 947-8405

NPI assigned

Jun 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Minh-Phuong Bui, D.M.D.

Title

President

Phone

(508) 947-5717

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Gerald Francis Masaitis, DDS

  • Endodontics
  • Lakeville, MA
  • NPI 1639198864
  NPD (past)

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1588928147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BEDFORD ST",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023472136",
            "telephone_number": "508-947-5717",
            "fax_number": "508-947-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 BEDFORD ST",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023472136",
            "telephone_number": "508-947-5717",
            "fax_number": "508-947-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "MINH-PHUONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-947-5717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110068471A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Sherman
• Jessica Anne Marie Smith, M. ED.
• Sally Smith
• Southcoast Physicians Group, Inc.
• Southeast Orthodontics, Inc.
• Southern Massachusetts Dental, P.C. (Lakeville Dental)
• Stephanie Mary Souza
• Spill the Tea Psychotherapy LLC
• Jessica Kristina Spivey, C-NP, PMHNP-BC
• Emily Anita St.Laurent

• General Practice Dentistry in Lakeville, MA
• Providers in Lakeville, 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 Jun 28, 2012; 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.