NPIMap

Organization Active NPI

Berkshire Pediatric Dentistry, PC

  • Pediatric Dentistry
  • Pittsfield, MA
National Provider Identifier
1669641957
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
18214 Issued in MA
Legal business name
BERKSHIRE PEDIATRIC DENTISTRY, PC
Practice address
77 Elm St
Pittsfield, MA 01201-6503
Phone
(413) 442-0122
NPI assigned
Feb 21, 2008
Last updated
Mar 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Dr. Lisa C Gamache, DMDNPI 1619995537
Title
Pediatric Dentist
Phone
(413) 442-0122

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 18214 MA Primary

Addresses

Primary practice location

77 Elm St
Pittsfield, MA 01201-6503

Mailing address

77 Elm St
Pittsfield, MA 01201-6503
Phone (413) 442-0122

National Provider Directory

National Provider Directory

Locations

77 Elm St
Pittsfield, MA 01201
Phone (413) 442-0122

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1669641957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ELM ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016503",
            "telephone_number": "413-442-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ELM ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016503",
            "telephone_number": "413-442-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKSHIRE PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "GAMACHE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "413-442-0122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "18214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.