Southbridge Braces PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN20511 Issued in MA

Legal business name

SOUTHBRIDGE BRACES PC

Practice address

39 Elm St
Suite 301
Southbridge, MA 01550-2644

Phone

(508) 909-6719

NPI assigned

Feb 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Houssam Alkhoury, DMD

Title

President

Phone

(508) 505-5040

Specialties & licenses 1

Addresses

Other names 1

• Super Braces Doing business as

Locations

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1699214593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 ELM ST",
            "address_2": "THIRD FLOOR",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481638",
            "telephone_number": "508-589-8270",
            "fax_number": "508-319-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ELM ST",
            "address_2": "SUITE 301",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015502644",
            "telephone_number": "508-909-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBRIDGE BRACES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "ALKHOURY",
        "authorized_official_first_name": "HOUSSAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-505-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN20511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yaritza Solero, LCSW
• Charles A Sommer, MD
• Shaukat Soofi, APRN
• Adrienne Ellen Soucy
• South County Therapies LLC
• Southbridge Dental LLC
• Southbridge Ma SNF LLC
• Southbridge OB GYN Assoc
• Southbridge Public School
• Southbridge Public Schools

• Orthodontics and Dentofacial Orthopedics Dentistry in Southbridge, MA
• Providers in Southbridge, MA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.