NPIMap

Organization Active NPI

Mass Kidz Healthy Smiles LLC

  • Exclusive Provider Organization
  • Braintree, MA
National Provider Identifier
1952658056
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
DH11340 Issued in MA
Legal business name
MASS KIDZ HEALTHY SMILES LLC
Practice address
126 Audubon Ave
Braintree, MA 02184-2352
Phone
(617) 913-3321
Fax
(781) 817-6135
NPI assigned
Aug 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Authorized official

Name
Mrs. Kathleen M Luisi, R.D.H.NPI 1477867703
Title
Manager
Phone
(617) 913-3321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X DH11340 MA Primary

Addresses

Primary practice location

126 Audubon Ave
Braintree, MA 02184-2352

Mailing address

126 Audubon Ave
Braintree, MA 02184-2352
Phone (617) 913-3321

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1952658056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 AUDUBON AVE",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842352",
            "telephone_number": "617-913-3321",
            "fax_number": "781-817-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AUDUBON AVE",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842352",
            "telephone_number": "617-913-3321",
            "fax_number": "781-817-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASS KIDZ HEALTHY SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "LUISI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-913-3321",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.D.H."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "DH11340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.