NPIMap

Organization Active NPI

Southeast Orthodontics, Inc.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dartmouth, MA
National Provider Identifier
1699226100
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
19702 Issued in MA
Legal business name
SOUTHEAST ORTHODONTICS, INC.
Practice address
408 State Rd
Suite 730
Dartmouth, MA 02747-4302
Phone
(508) 990-3000
Fax
(508) 990-3080
NPI assigned
Oct 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Dr. Brian R. Gaudreault, D.M.D.
Title
President
Phone
(508) 880-5891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 19702 MA Primary

Addresses

Primary practice location

408 State Rd
Suite 730
Dartmouth, MA 02747-4302

Mailing address

302 Broadway
Unit 6
Raynham, MA 02767-1439
Phone (508) 880-5891

National Provider Directory

National Provider Directory
Tax ID family
Southeast Orthodontics Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

408 State Rd
Ste 730
Dartmouth, MA 02747
Phone (508) 990-3000

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1699226100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BROADWAY",
            "address_2": "UNIT 6",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671439",
            "telephone_number": "508-880-5891",
            "fax_number": "508-802-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 STATE RD",
            "address_2": "SUITE 730",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027474302",
            "telephone_number": "508-990-3000",
            "fax_number": "508-990-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORTHODONTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "GAUDREAULT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-880-5891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "19702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.