Jerome Morris Azia, D.D.S, – Dentist in Southwick, MA

Key facts

NPI: 1639192073
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 12383 (MA)
Practice address: 5 Falcon CRST
Southwick, MA 01077-9346
Phone: (413) 265-1673
NPI assigned: Jul 26, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Jerome M. Azia D.D.S.,P.C. Dentist · Southwick, MA · NPI 1366465791

NPD (past) Authorized official DENTIST

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
12383	MA	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Jerome M. Azia D.D.S.,P.C.	Dentist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	12383	MA	Yes

Addresses

Primary practice location

5 Falcon CRST
Southwick, MA 01077-9346

Mailing address

5 Falcon CRST
Southwick, MA 01077-9346
Phone (413) 265-1673

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 20, 2019.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571529600000",
    "number": "1639192073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FALCON CRST",
            "city": "SOUTHWICK",
            "state": "MA",
            "postal_code": "010779346",
            "telephone_number": "413-265-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FALCON CRST",
            "city": "SOUTHWICK",
            "state": "MA",
            "postal_code": "010779346",
            "telephone_number": "413-265-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIA",
        "first_name": "JEROME",
        "middle_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "12383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southwick, MA

All providers in Southwick, MA · Dentist in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.