Great Woods Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17639 Issued in MA

Legal business name

GREAT WOODS FAMILY DENTISTRY

Practice address

792 S Main St
Suite 24
Mansfield, MA 02048-3137

Phone

(508) 339-4171

Fax

(508) 339-4171

NPI assigned

Jun 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Wahid Mistikawi, D.M.D.NPI 1710135033

Title

Owner/Doctor

Phone

(508) 339-4171

Specialties & licenses 1

Addresses

Tax ID family

Great Woods Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wahid Mistikawi Dba Greatwoods Family Dentistry

  • Preferred Provider Organization
  • Mansfield, MA
  • NPI 1417399270
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wahid Mistikawi, D.M.D. P.C.

  • Dentist
  • Murrells Inlet, SC
  • NPI 1710135033
  NPD (past) Authorized official

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1841670262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 S MAIN ST",
            "address_2": "SUITE 24",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020483137",
            "telephone_number": "508-339-4171",
            "fax_number": "508-339-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 S MAIN ST",
            "address_2": "SUITE 24",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020483137",
            "telephone_number": "508-339-4171",
            "fax_number": "508-339-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT WOODS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "MISTIKAWI",
        "authorized_official_first_name": "WAHID",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "508-339-4171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN17639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Ginsberg, DMD
• Stephan Ginsberg, DMD
• Emma Brooks Goulet
• Melissa Goulet, PHARM D
• Alissa J Grace, MS,CCC
• Paul Theodore Greiner, MD
• Amit Johnny Grover, M.D.
• Masud Habibullah, MD
• Hannah Haleudeth, CCC-SLP
• Carol Anne Hamilton-Dodd, MA, OTR/L

• General Practice Dentistry in Mansfield, MA
• Providers in Mansfield, 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 Jun 1, 2015; 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.