Individual provider Active NPI

Jason Douglas Robillard, D.M.D.

  • Dentist
  • Georgetown, MA
National Provider Identifier
1639418619
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21339 Issued in MA
Practice address
25 E Main St
Georgetown, MA 01833-2007
Phone
(978) 352-8206
Fax
(978) 352-8853
NPI assigned
Feb 11, 2013
Last updated
Feb 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21339 MA Primary

Addresses

Primary practice location

25 E Main St
Georgetown, MA 01833-2007

Mailing address

25 E Main St
Georgetown, MA 01833-2007
Phone (978) 352-8206

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
I20150715000251 MA Order and Referring Only - DentistPractitioner - Dentist 8022321488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21339MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Veritas Prosthodontics, P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1639418619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E MAIN ST",
            "city": "GEORGETOWN",
            "state": "MA",
            "postal_code": "018332007",
            "telephone_number": "978-352-8206",
            "fax_number": "978-352-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E MAIN ST",
            "city": "GEORGETOWN",
            "state": "MA",
            "postal_code": "018332007",
            "telephone_number": "978-352-8206",
            "fax_number": "978-352-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBILLARD",
        "first_name": "JASON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN21339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, MA

Sources for this page

Verify at the official NPI Registry.