Active NPI
Paul E Tesone DDS Inc
- Oral and Maxillofacial Surgery (Dentist)
- Everett, MA
National Provider Identifier
1770787442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 11620
- Legal business name
- PAUL E TESONE DDS INC
- Practice address
- 563 Broadway
Suite 4
Everett, MA 02149 - Phone
- (617) 389-4950
- Fax
- (617) 389-8604
- NPI assigned
- Jun 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Paul E Tesone, DDS
- Title
- Owner
- Phone
- (617) 389-4950
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 11620 | MA | Primary |
Addresses
Primary practice location
563 Broadway
Suite 4
Everett, MA 02149
Mailing address
563 Broadway S
Suite 4
Everett, MA 02149
Phone (617) 389-4950
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X11108 | Other | MA | BCBS |
| X03773 | Other | MA | BCBS |
| 0230111 | Medicaid | MA |
National Provider Directory
National Provider DirectoryLocations
563 Broadway
Ste 4
Everett, MA 02149
Phone (617) 389-4950
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Everett, MA
- NPI 1184779977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1770787442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 BROADWAY S",
"address_2": "SUITE 4",
"city": "EVERETT",
"state": "MA",
"postal_code": "02149",
"telephone_number": "617-389-4950",
"fax_number": "617-389-8604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "563 BROADWAY",
"address_2": "SUITE 4",
"city": "EVERETT",
"state": "MA",
"postal_code": "02149",
"telephone_number": "617-389-4950",
"fax_number": "617-389-8604"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL E TESONE DDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TESONE",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "617-389-4950",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MA",
"license": "11620",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "X11108",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "X03773",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0230111",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.