Super Dental of Worcester PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SUPER DENTAL OF WORCESTER PLLC

Practice address

227 Russell St
Worcester, MA 01602-2126

Phone

(508) 589-8270

NPI assigned

Oct 21, 2022

Organization subpart

No

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

Authorized official

Name

Aimee Hodgerney

Title

Credentialing

Phone

(508) 589-8270

Specialties & licenses 1

Addresses

Other names 1

• Community Dentists of Worcester Doing business as

Locations

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1689391567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 RUSSELL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 RUSSELL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022126",
            "telephone_number": "508-589-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER DENTAL OF WORCESTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "HODGERNEY",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "508-589-8270"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dentists of Worcester",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Dentists of Worcester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Worcester, MA
• Providers in Worcester, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.