NPIMap

Organization Active NPI

Dale M Wetmore DDS PC

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1841213295
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21163 Issued in MA
Legal business name
DALE M WETMORE DDS PC
Practice address
29 Commonwealth Avenue
#305
Boston, MA 02116
Phone
(617) 536-7168
Fax
(617) 536-6634
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dale Melvin Wetmore, DDSNPI 1154335545
Title
President
Phone
(617) 536-7168

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12755 MA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 21163 MA Primary

Addresses

Primary practice location

29 Commonwealth Avenue
#305
Boston, MA 02116

Mailing address

29 Commonwealth Avenue
#305
Boston, MA 02116
Phone (617) 536-7168

Other identifiers 1

IdentifierTypeStateIssuer
X11920OtherMABCBS

National Provider Directory

National Provider Directory

Locations

29 Commonwealth Ave
#305
Boston, MA 02116
Phone (617) 536-7168

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841213295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 COMMONWEALTH AVENUE",
            "address_2": "#305",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-536-7168",
            "fax_number": "617-536-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 COMMONWEALTH AVENUE",
            "address_2": "#305",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-536-7168",
            "fax_number": "617-536-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE M WETMORE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WETMORE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "MELVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-536-7168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12755",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "X11920",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, 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.

Verify at the official NPI Registry.