Individual provider Active NPI

Carolyn B. Swain, D.D.S., M.S.

  • Dentist
  • Oak Bluffs, MA
National Provider Identifier
1629291547
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1855880 Issued in MA
Practice address
1 Hospital Road
Oak Bluffs, MA 02557
Phone
(508) 693-6872
Fax
(508) 696-4157
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1855880 MA Primary
General Practice Dentistry 1223G0001X 008098 CT

Addresses

Primary practice location

1 Hospital Road
Oak Bluffs, MA 02557

Mailing address

1 Hospital Road
Oak Bluffs, MA 02557
Phone (508) 693-6872

Other identifiers 1

IdentifierTypeStateIssuer
004236122MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161114001622 MA Order and Referring Only - DentistPractitioner - Dentist 8123307261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1855880MAMDDentist
008098CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1629291547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "02557",
            "telephone_number": "508-693-6872",
            "fax_number": "508-696-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "02557",
            "telephone_number": "508-693-6872",
            "fax_number": "508-696-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "CAROLYN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "1855880",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008098",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236122",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Bluffs, MA

Sources for this page

Verify at the official NPI Registry.