NPIMap

Organization Active NPI

Yarmouth Periodontics LLC

  • Periodontics
  • West Yarmouth, MA
National Provider Identifier
1619305372
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
18818 Issued in MA
Legal business name
YARMOUTH PERIODONTICS LLC
Practice address
30 Higgins Crowell Rd
West Yarmouth, MA 02673-3444
Phone
(508) 775-6996
NPI assigned
Oct 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Dr. Dennis J Jodoin, DMD
Title
Owner
Phone
(508) 775-6996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 18818 MA Primary

Addresses

Primary practice location

30 Higgins Crowell Rd
West Yarmouth, MA 02673-3444

Mailing address

30 Higgins Crowell Rd
West Yarmouth, MA 02673-3444

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1619305372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HIGGINS CROWELL RD",
            "city": "WEST YARMOUTH",
            "state": "MA",
            "postal_code": "026733444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HIGGINS CROWELL RD",
            "city": "WEST YARMOUTH",
            "state": "MA",
            "postal_code": "026733444",
            "telephone_number": "508-775-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YARMOUTH PERIODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "JODOIN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-775-6996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "18818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Yarmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.