Robert A. Faiella, D.M.D., M.M.SC.

Individual provider Active NPI Periodontics · Osterville, MA

NPI 1891910568 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1891910568
Entity type
Individual (NPI type 1)
Primary specialty
Periodontics 1223P0300X
License
15238 (MA)
Practice address
749 Main St
Suite B
Osterville, MA 02655-1944
Phone
(508) 420-1124
Fax
(508) 420-0904
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15238MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert a. Faiella, DMD, MMSC, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 15238 MA Yes

Addresses

Primary practice location

749 Main St
Suite B
Osterville, MA 02655-1944

Mailing address

749 Main St
Suite B
Osterville, MA 02655-1944
Phone (508) 420-1124

Other providers in Osterville, MA

All providers in Osterville, MA · Periodontics in Massachusetts

Sources for this page

Verify at the official NPI Registry.