NPIMap

Organization Active NPI

Gustavo Perdomo, DMD, LLC

  • Dentist
  • Weymouth, MA
National Provider Identifier
1700052651
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21628 Issued in MA
Legal business name
GUSTAVO PERDOMO, DMD, LLC
Practice address
330 Washington St
Weymouth, MA 02188-2932
Phone
(781) 335-5300
NPI assigned
May 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Dr. Gustavo Perdomo, DMD
Title
Dentist
Phone
(781) 335-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 21628 MA Primary

Addresses

Primary practice location

330 Washington St
Weymouth, MA 02188-2932

Mailing address

330 Washington St
Weymouth, MA 02188-2932
Phone (781) 335-5300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1700052651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WASHINGTON ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021882932",
            "telephone_number": "781-335-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WASHINGTON ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021882932",
            "telephone_number": "781-335-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAVO PERDOMO, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "PERDOMO",
        "authorized_official_first_name": "GUSTAVO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-335-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "21628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.