The Loose Tooth

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

DH11413 Issued in MA

Legal business name

THE LOOSE TOOTH

Practice address

874 Prospect St
Chicopee, MA 01020-3107

Phone

(413) 888-6767

Fax

(413) 888-6766

NPI assigned

Mar 2, 2011

Last updated

Mar 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Hauschild, RDH, PHDHNPI 1588969687

Title

Owner, Opperator

Phone

(413) 888-6767

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Lynn Hauschild, RDH

  • Dental Hygienist
  • Chicopee, MA
  • NPI 1588969687
  NPD (past) Authorized official

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1750689576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 PROSPECT ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203107",
            "telephone_number": "413-888-6767",
            "fax_number": "413-888-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 PROSPECT ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010203107",
            "telephone_number": "413-888-6767",
            "fax_number": "413-888-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LOOSE TOOTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "HAUSCHILD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER, OPPERATOR",
        "authorized_official_telephone_number": "14138886767",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDH, PHDH"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MA",
            "license": "DH11413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Louise Tatgenhorst
• Stacey Ann Temple, C.N.M.
• Abbey Lucey Tenczar
• Monica N Tews
• The Commonwealth of Massachusetts
• The Northeast Health Group, Inc (Willimansett Center West)
• The Northeast Health Group, Inc (Willimansett Center East)
• The Stop & Shop Supermarket Company LLC (Stop and Shop Pharmacy #36)
• Kristen Thiel, LMT
• Alison L Thirkield, PH.D.

• Health Maintenance Organization in Chicopee, MA
• Providers in Chicopee, MA by specialty
• Health Maintenance Organization in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.