NPIMap

Organization Active NPI

Coastal Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Hingham, MA
National Provider Identifier
1740545144
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
219506 Issued in MA
Legal business name
COASTAL PLASTIC SURGERY, LLC
Practice address
2 Pond Park Rd Ste 308
Coastal Plastic Surgery LLC
Hingham, MA 02043-4354
Phone
(781) 740-7840
Fax
(781) 740-9840
NPI assigned
Jul 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Dr. Dax Guenther, MD
Title
Sole MBR
Phone
(781) 740-7840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 219506 MA Primary

Addresses

Primary practice location

2 Pond Park Rd Ste 308
Coastal Plastic Surgery LLC
Hingham, MA 02043-4354

Mailing address

2 Pond Park Rd Ste 308
Coastal Plastic Surgery LLC
Hingham, MA 02043-4354
Phone (781) 740-7840

National Provider Directory

National Provider Directory

Locations

2 Pond Park Rd
Ste 308
Hingham, MA 02043
Phone (781) 740-7840

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1740545144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POND PARK RD STE 308",
            "address_2": "COASTAL PLASTIC SURGERY LLC",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434354",
            "telephone_number": "781-740-7840",
            "fax_number": "781-740-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POND PARK RD STE 308",
            "address_2": "COASTAL PLASTIC SURGERY LLC",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434354",
            "telephone_number": "781-740-7840",
            "fax_number": "781-740-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "GUENTHER",
        "authorized_official_first_name": "DAX",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "781-740-7840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "219506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.