MGS Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21083 Issued in MA

Legal business name

MGS DENTAL PC

Practice address

1756 Main St
Tewksbury, MA 01876-2003

Phone

(857) 919-6470

NPI assigned

Apr 26, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mikhail Gomer, DMD

Title

President

Phone

(857) 919-6470

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1942527239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PIPERS GLN",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102336",
            "telephone_number": "857-919-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762003",
            "telephone_number": "857-919-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGS DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "GOMER",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "857-919-6470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tewksbury, MA
• Providers in Tewksbury, 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 Apr 26, 2010; 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.