Dartmouth Periodontics & Implant Dentistry,PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DL22306 Issued in MA

Legal business name

DARTMOUTH PERIODONTICS & IMPLANT DENTISTRY,PC

Practice address

41 State Rd
North Dartmouth, MA 02747-3319

Phone

(508) 993-9105

Fax

(508) 993-9115

NPI assigned

Feb 18, 2014

Last updated

Feb 18, 2014By 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

Dr. Soowoo Kim, D.M.D.

Title

President

Phone

(508) 993-9105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1780008383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 STATE RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027473319",
            "telephone_number": "508-993-9105",
            "fax_number": "508-993-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 STATE RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027473319",
            "telephone_number": "508-993-9105",
            "fax_number": "508-993-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARTMOUTH PERIODONTICS & IMPLANT DENTISTRY,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SOOWOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-993-9105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DL22306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica S Da Silva, MD
• Marissa Daluz, PT
• Dartmouth Assisted Living, LLC (Heritage at Dartmouth)
• Dartmouth Medical Walk in PC III
• Dartmouth Pediatrics
• Season Dasilva, LICSW
• Carlos R. Defreitas, O.D.
• Lawrence R Dehner, MD
• Patricia Jeanne Delaney
• Adam Deletetsky, PHARMD

• Periodontics in North Dartmouth, MA
• Providers in North Dartmouth, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.