Pallavi Dahake, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1857053 Issued in MA

Practice address

70 Westgate Dr
Brockton, MA 02301-1811

Phone

(508) 588-8090

NPI assigned

Jan 7, 2016

Last updated

Jan 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brockton Smiles Youth Dentistry, LLC

  • General Practice Dentistry
  • Brockton, MA
  • NPI 1851581243
  NPD (past)

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1801252739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011811",
            "telephone_number": "508-588-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011811",
            "telephone_number": "508-588-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHAKE",
        "first_name": "PALLAVI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edina Da Silva
• Diane M. Daddario, M.D.
• Megan Nicole Dadez, OTD, OTR/L
• Leonard Paul Dagesse
• Walid Ibrahim Dagher, MD
• Sue Ellen Daigle-Gillis, LMHC
• Valencia Dailey-Reid, LICSW
• Kerry Marie Dailey, TEACHER CERTIFICATIO
• Daily Plus Pharmacy LLC
• Jennifer Daks, PHD

• General Practice Dentistry in Brockton, MA
• Providers in Brockton, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.