Donald P Prohovich, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15891 Issued in MA

Practice address

44 Center Street
North Easton, MA 02356-0074

Phone

(508) 238-3313

Fax

(508) 238-6991

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649290222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "address_2": "44 CENTER STREET",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023560074",
            "telephone_number": "508-238-3313",
            "fax_number": "508-238-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 CENTER STREET",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023560074",
            "telephone_number": "508-238-3313",
            "fax_number": "508-238-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROHOVICH",
        "first_name": "DONALD",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265993",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9776052",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lothida Phothisane
• Susan K Plante, APRN
• Jose Roman Polanco, MD
• Robert Charles Portman, PSY.D.
• Robert S Powell, D.O.
• Mia Pruett, PH.D.
• Psychological Associates of Southeastern Massachusetts, LLC
• Jacqueline Pucillo
• Cailey Purcell
• Nina M. Quinn, BCBA, LABA

• General Practice Dentistry in North Easton, MA
• Providers in North Easton, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.