NPIMap

Organization Active NPI

Ralph P. Pollack, DMD MSCD PC

  • Periodontics
  • Dartmouth, MA
National Provider Identifier
1841433166
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
11062 Issued in MA
Legal business name
RALPH P. POLLACK, DMD MSCD PC
Practice address
41 State Rd
Dartmouth, MA 02747-3319
Phone
(508) 993-9105
Fax
(508) 993-9115
NPI assigned
Apr 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Authorized official

Name
Dr. Ralph P Pollack, D.M.D.
Title
President
Phone
(508) 993-9105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 11062 MA Primary

Addresses

Primary practice location

41 State Rd
Dartmouth, MA 02747-3319

Mailing address

41 State Rd
Dartmouth, MA 02747-3319
Phone (508) 993-9105

Other identifiers 1

IdentifierTypeStateIssuer
9796584MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1841433166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 STATE RD",
            "city": "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": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027473319",
            "telephone_number": "508-993-9105",
            "fax_number": "508-993-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH P. POLLACK, DMD MSCD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "P",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "11062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9796584",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.