NPIMap

Organization Active NPI

Mattapan Community Health Center

  • Dental Clinic/Center
  • Mattapan, MA
National Provider Identifier
1962889162
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
88716 Issued in MA
Legal business name
MATTAPAN COMMUNITY HEALTH CENTER
Practice address
1575 Blue Hill Ave
Mattapan, MA 02126-2122
Phone
(617) 296-0061
NPI assigned
Apr 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Mr. Henry Workman
Title
Director
Phone
(617) 898-9041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 88716 MA Primary

Addresses

Primary practice location

1575 Blue Hill Ave
Mattapan, MA 02126-2122

Mailing address

1575 Blue Hill Ave
Mattapan, MA 02126-2122

National Provider Directory

National Provider Directory
Tax ID family
FQHC Facility3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1962889162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262122",
            "telephone_number": "617-296-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTAPAN COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-898-9041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "88716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.