Individual provider Active NPI

Randy Scott Weiner, DMD

  • General Practice Dentistry
  • Millis, MA
National Provider Identifier
1710917661
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16482 Issued in MA
Practice address
10 Pleasant St
Millis, MA 02054-1409
Phone
(508) 376-4949
Fax
(508) 376-1919
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16482 MA Primary

Addresses

Primary practice location

10 Pleasant St
Millis, MA 02054-1409

Mailing address

10 Pleasant St
Millis, MA 02054-1409
Phone (508) 376-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140912001708 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759500341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710917661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PLEASANT ST",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541409",
            "telephone_number": "508-376-4949",
            "fax_number": "508-376-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PLEASANT ST",
            "city": "MILLIS",
            "state": "MA",
            "postal_code": "020541409",
            "telephone_number": "508-376-4949",
            "fax_number": "508-376-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "RANDY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millis, MA

Sources for this page

Verify at the official NPI Registry.