NPIMap

Organization Active NPI

Medway Family Dental PLLC

  • General Practice Dentistry
  • Medway, MA
National Provider Identifier
1750872636
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20694 Issued in MA
Legal business name
MEDWAY FAMILY DENTAL PLLC
Doing business as
Medway Family Dental
Practice address
131 Main St
Medway, MA 02053-1576
Phone
(508) 533-7461
Fax
(508) 533-7455
NPI assigned
May 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Edmond Massabni
Title
DDS/Owner
Phone
(508) 473-7632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20694 MA Primary

Addresses

Primary practice location

131 Main St
Medway, MA 02053-1576

Mailing address

131 Main St
Medway, MA 02053-1576
Phone (508) 533-7461

Other names 1

  • Medway Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

131 Main St
Medway, MA 02053
Phone (508) 533-7461

Practitioners & affiliated clinicians

Practitioners 2

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": "1527206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1750872636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531576",
            "telephone_number": "508-533-7461",
            "fax_number": "508-533-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531576",
            "telephone_number": "508-533-7461",
            "fax_number": "508-533-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWAY FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-25",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "MASSABNI",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "508-473-7632"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medway Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medway, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.