NPIMap

Organization Active NPI

Barry Puchkoff DMD,PC

  • Dental Clinic/Center
  • Tewksbury, MA
National Provider Identifier
1649453812
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9170 Issued in MA
Legal business name
BARRY PUCHKOFF DMD,PC
Practice address
1756 Main St
Tewksbury, MA 01876-2003
Phone
(978) 851-7012
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Dr. Barry Puchkoff, DMD
Title
President
Phone
(978) 851-7012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9170 MA Primary

Addresses

Primary practice location

1756 Main St
Tewksbury, MA 01876-2003

Mailing address

1756 Main St
Tewksbury, MA 01876-2003
Phone (978) 851-7012

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1649453812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762003",
            "telephone_number": "978-851-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762003",
            "telephone_number": "978-851-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY PUCHKOFF DMD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "PUCHKOFF",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-851-7012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "9170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.