Individual provider Active NPI

Netma Elizabeth Fierro Carrillo

  • General Practice Dentistry
  • North Adams, MA
National Provider Identifier
1619612850
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DL15169 Issued in MA
Practice address
77 Hospital Ave Ste 102
North Adams, MA 01247-2538
Phone
(413) 346-4242
Fax
(413) 346-4029
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DL15169 MA Primary

Addresses

Primary practice location

77 Hospital Ave Ste 102
North Adams, MA 01247-2538

Mailing address

77 Hospital Ave Ste 102
North Adams, MA 01247-2538
Phone (413) 346-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DL15169MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Support & Healing Ministries Inc CurrentSince Oct 27, 2024 Accepting new patients
Hillcrest Dental Care Inc General Practice PastSince May 8, 2022 Accepting new patients

Locations

77 Hospital Ave
Ste 102
North Adams, MA 01247
Phone (413) 346-4242

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1619612850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVE STE 102",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472538",
            "telephone_number": "413-346-4242",
            "fax_number": "413-346-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVE STE 102",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472538",
            "telephone_number": "413-346-4242",
            "fax_number": "413-346-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIERRO CARRILLO",
        "first_name": "NETMA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DL15169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Adams, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.