NPIMap

Organization Active NPI

Mdsa LLC

  • Periodontics
  • Methuen, MA
National Provider Identifier
1871839530
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN20469 Issued in MA
Legal business name
MDSA LLC
Practice address
380 Merrimack St
Suite 3a
Methuen, MA 01844-5870
Phone
(978) 685-2471
Fax
(978) 683-3985
NPI assigned
Dec 27, 2012
Last updated
Dec 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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

Authorized official

Name
Dr. Gary H Wainwright, D.M.D.NPI 1669525085
Title
Member
Phone
(978) 685-2471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN16836 MA
Periodontics 1223P0300X DN20469 MA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 16114 MA

Addresses

Primary practice location

380 Merrimack St
Suite 3a
Methuen, MA 01844-5870

Mailing address

380 Merrimack St
Suite 3a
Methuen, MA 01844-5870
Phone (978) 685-2471

National Provider Directory

National Provider Directory

Locations

380 Merrimack St
Ste 3A
Methuen, MA 01844
Phone (978) 685-2471

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1871839530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 3A",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-685-2471",
            "fax_number": "978-683-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MERRIMACK ST",
            "address_2": "SUITE 3A",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018445870",
            "telephone_number": "978-685-2471",
            "fax_number": "978-683-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "WAINWRIGHT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "978-685-2471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN16836",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN20469",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "16114",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; 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.