NPIMap

Organization Active NPI

Simply Dental at Worcester, PLLC

  • Dental Clinic/Center
  • Worcester, MA
National Provider Identifier
1750024378
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIMPLY DENTAL AT WORCESTER, PLLC
Doing business as
Dr. Stephen Waxman
Practice address
255 Park Ave Ste 904
Worcester, MA 01609-1978
Phone
(508) 589-8270
NPI assigned
Apr 20, 2022
Organization subpart
Yes
Parent organization
SIMPLY DENTAL AT WORCESTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Aimee Hodgerney
Title
Credentialing
Phone
(508) 589-8270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

255 Park Ave Ste 904
Worcester, MA 01609-1978

Mailing address

87 Elm St
Hopkinton, MA 01748-1638
Phone (508) 589-8270

Other names 1

  • Dr. Stephen Waxman Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Simply Dental at Worcester PLLC3 organizations share this tax ID, including this one
Part of
Simply Dental at Worcester PLLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1750024378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 ELM ST",
            "city": "HOPKINTON",
            "state": "MA",
            "postal_code": "017481638",
            "telephone_number": "508-589-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE STE 904",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091978",
            "telephone_number": "508-589-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY DENTAL AT WORCESTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIMPLY DENTAL AT WORCESTER, PLLC",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "HODGERNEY",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "508-589-8270"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Stephen Waxman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.