NPIMap

Organization Active NPI

South Shore Periodontics LLP

  • Periodontics
  • Hingham, MA
National Provider Identifier
1669566519
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
18143 Issued in MA
Legal business name
SOUTH SHORE PERIODONTICS LLP
Practice address
175 Derby Street
Suite #11
Hingham, MA 02043
Phone
(781) 749-9444
Fax
(781) 749-4487
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James T Ubertalli, DMDNPI 1851317143
Title
Owner Partner
Phone
(781) 749-9444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 18143 MA Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 19645 MA

Addresses

Primary practice location

175 Derby Street
Suite #11
Hingham, MA 02043

Mailing address

175 Derby Street
Suite #11
Hingham, MA 02043
Phone (781) 749-9444

National Provider Directory

National Provider Directory

Locations

175 Derby St
Ste 11
Hingham, MA 02043
Phone (781) 749-9444

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669566519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 DERBY STREET",
            "address_2": "SUITE #11",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "02043",
            "telephone_number": "781-749-9444",
            "fax_number": "781-749-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 DERBY STREET",
            "address_2": "SUITE #11",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "02043",
            "telephone_number": "781-749-9444",
            "fax_number": "781-749-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PERIODONTICS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UBERTALLI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER PARTNER",
        "authorized_official_telephone_number": "781-749-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "18143",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "19645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.