Holyoke Smiles Youth Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HOLYOKE SMILES YOUTH DENTISTRY, LLC

Practice address

2255 N Hampton St
Holyoke, MA 01040-3447

Phone

(413) 534-8700

Fax

(413) 534-8701

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jenell Stump

Title

Manager, Licensing & Credentialing

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1851570162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 N HAMPTON ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010403447",
            "telephone_number": "413-534-8700",
            "fax_number": "413-534-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLYOKE SMILES YOUTH DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "STUMP",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110077874A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holyoke Operator LLC (MiraVista Behavioral Health Center)
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• Holyoke Pediatric Associates, LLP
• Holyoke Radiologists Inc
• Holyoke Retirement Community Inc. (Loomis House)
• Holyoke Sud, LLC (MiraVista Behavioral Health Center)
• Holyoke Visiting Nurse Association, Inc. (Holyoke VNA & Hospice Life Care)
• Holyoke Visiting Nurse Association, Inc. (Holyoke VNA & Hospice Life Care)
• Home Health Solutions
• Karen Horgan

• General Practice Dentistry in Holyoke, MA
• Providers in Holyoke, 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 Jul 9, 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.