NPIMap

Organization Active NPI

Common Park Dental

  • Dentist
  • Worcester, MA
National Provider Identifier
1699125708
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857233 Issued in MA
Legal business name
COMMON PARK DENTAL
Practice address
111 Elm St
Suite 203
Worcester, MA 01609-1967
Phone
(508) 502-7881
NPI assigned
Jun 20, 2016
Last updated
Jun 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Kevin Guze, DMD
Title
Owner
Phone
(508) 502-7881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857233 MA Primary

Addresses

Primary practice location

111 Elm St
Suite 203
Worcester, MA 01609-1967

Mailing address

111 Elm St
Suite 203
Worcester, MA 01609-1967

National Provider Directory

National Provider Directory
Tax ID family
Common Park Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1699125708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "address_2": "SUITE 203",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "address_2": "SUITE 203",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091967",
            "telephone_number": "508-502-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMON PARK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "GUZE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-502-7881",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.