Mario Thevenin

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN10000926 Issued in MA

Practice address

698 Crescent St
Brockton, MA 02302-3360

Phone

(508) 583-2256

NPI assigned

Jun 30, 2023

Last updated

Jul 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dental Dreams, LLC

  • Dentist
  • Brockton, MA
  • NPI 1144498726
  NPD (past)

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1932886066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WINN PARK APT A",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013061",
            "telephone_number": "789-189-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 CRESCENT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023360",
            "telephone_number": "508-583-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-998-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEVENIN",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN10000926",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa M Smith (South of Boston Healing)
• Fritzlaine Thermidor
• Rachelle Alessandra Thermora, PHARM D
• Jay Muruga Theva, D.M.D
• Mathi Theva
• Thibaud Healthcare Agency LLC
• Deirdre Thibault
• Jonathan Thibault
• Kristine Marie Thibault, M. ED.
• Armand Thibodeau, D.P.T.

• General Practice Dentistry in Brockton, MA
• Providers in Brockton, 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 4, 2025; 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.