NPIMap

Organization Active NPI

Smilecare Dental of Fitchburg PC

  • General Practice Dentistry
  • Fitchburg, MA
National Provider Identifier
1770185324
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILECARE DENTAL OF FITCHBURG PC
Practice address
164 Elm St
Fitchburg, MA 01420-3192
Phone
(978) 345-5563
NPI assigned
Nov 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Dr. Kadambari Glen ColacoNPI 1295184869
Title
Dentist
Phone
(716) 541-4566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

164 Elm St
Fitchburg, MA 01420-3192

Mailing address

24 Dewey Rd
Lexington, MA 02420-1018

National Provider Directory

National Provider Directory

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": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1770185324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DEWEY RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024201018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 ELM ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203192",
            "telephone_number": "978-345-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILECARE DENTAL OF FITCHBURG PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "COLACO",
        "authorized_official_first_name": "KADAMBARI",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "716-541-4566",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.