Individual provider Active NPI

Philip J Cabrera, D.D.S., F.R.C.D. (C)

  • Endodontics
  • Worcester, MA
National Provider Identifier
1629068820
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
20003 Issued in MA
Practice address
255 Park Ave
Suite 1020
Worcester, MA 01609-1953
Phone
(508) 792-4290
Fax
(508) 792-0295
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 20003 MA Primary

Addresses

Primary practice location

255 Park Ave
Suite 1020
Worcester, MA 01609-1953

Mailing address

255 Park Ave
Suite 1020
Worcester, MA 01609-1953
Phone (508) 792-4290

Other identifiers 2

IdentifierTypeStateIssuer
20003OtherMASTATE LICENSE NUMBER
11-12-0000MedicaidMA

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
20003MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629068820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 1020",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-792-4290",
            "fax_number": "508-792-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "address_2": "SUITE 1020",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-792-4290",
            "fax_number": "508-792-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "PHILIP",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S., F.R.C.D. (C)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "20003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "20003",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11-12-0000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.