Bagnall Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1856571 Issued in MA

Legal business name

BAGNALL FAMILY DENTISTRY, LLC

Practice address

16 Haverhill St
Andover, MA 01810-3002

Phone

(978) 475-3997

Fax

(978) 409-6065

NPI assigned

Feb 26, 2018

Last updated

Feb 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Lee Bagnall, DMDNPI 1205109436

Title

Owner

Phone

(978) 475-3997

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Lee Bagnall, D.M.D.

  • General Practice Dentistry
  • Andover, MA
  • NPI 1205109436
  Authorized official Same address or phone

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1851892723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HAVERHILL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103002",
            "telephone_number": "978-475-3997",
            "fax_number": "978-409-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HAVERHILL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103002",
            "telephone_number": "978-475-3997",
            "fax_number": "978-409-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAGNALL FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "BAGNALL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-475-3997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Athime, NURSE
• Avista Counseling Inc.
• Martina Azar, PHD
• Baba Oro LLC (The Positive Thinking)
• Vivian Baez
• Kevin Thomas Bagnall, D.D.S.
• Matthew Lee Bagnall, D.M.D.
• Jane Marie Bailey
• Lisa Bailyn, PH.D.
• Amanda Baker, BA

• General Practice Dentistry in Andover, MA
• Providers in Andover, 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 Feb 26, 2018; 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.