Individual provider Active NPI

William M Dupont, DDS

  • General Practice Dentistry
  • Chicopee, MA
National Provider Identifier
1669495016
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10639 Issued in MA
Practice address
505 Front St
Chicopee, MA 01013-3140
Phone
(413) 420-2222
Fax
(413) 592-2324
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10639 MA Primary

Addresses

Primary practice location

505 Front St
Chicopee, MA 01013-3140

Mailing address

505 Front St
Chicopee, MA 01013-3140
Phone (413) 420-2222

Other identifiers 1

IdentifierTypeStateIssuer
0210765MedicaidMA

Other names 1

  • William M Dupont Professional name

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
I20150709002299 MA Order and Referring Only - DentistPractitioner - Dentist 1557673175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10639MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1669495016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 FRONT ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010133140",
            "telephone_number": "413-420-2222",
            "fax_number": "413-592-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 FRONT ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010133140",
            "telephone_number": "413-420-2222",
            "fax_number": "413-592-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "10639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210765",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "DUPONT",
            "middle_name": "M",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.