Childrens Dentistry and Orthodontics of Chicopee 2 LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CHILDRENS DENTISTRY AND ORTHODONTICS OF CHICOPEE 2 LLC

Practice address

747 Memorial Dr
Chicopee, MA 01020-5022

Phone

(413) 593-3700

NPI assigned

May 5, 2022

Last updated

May 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

VP Insurance Plan Managment

Phone

(727) 424-2990

Specialties & licenses 1

Addresses

Other names 1

• Dental Care Alliance Other name

Tax ID family

Childrens Dentistry and Orthodontics of Chicopee 2 LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Childrens Dentistry and Orthodontics of Chicopee 2 LLC

  • Dentist
  • Chicopee, MA
  • NPI 1437890233
  NPD tax ID

Locations

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1629714431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 MEMORIAL DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010205022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 MEMORIAL DR",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010205022",
            "telephone_number": "413-593-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTISTRY AND ORTHODONTICS OF CHICOPEE 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "VP INSURANCE PLAN MANAGMENT",
        "authorized_official_telephone_number": "727-424-2990"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care Alliance",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chicopee Visiting Nurse Association
• Travis Stacin Chicot
• Children's Dentistry and Orthodontics of Chicopee 1 LLC
• Children's Dentistry of Chicopee
• Childrens Dentistry and Orthodontics of Chicopee 2 LLC
• Sheena Choquette
• Julia Ewa Chrostowski
• Michael Jongchil Chung, DDS
• Church Street Dental, PC
• Christopher Chutkowski, OTR/L

• Dentist in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.