NPIMap

Organization Active NPI

Bill Vagenas, DMD, LLC

  • General Practice Dentistry
  • Brockton, MA
National Provider Identifier
1982076774
Registry record updated Oct 20, 2015
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
X18888 Issued in MA
Legal business name
BILL VAGENAS, DMD, LLC
Practice address
5 Torrey St
Brockton, MA 02301-4832
Phone
(508) 586-4276
Fax
(508) 513-1403
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Vasilios Vagenas, DMD
Title
Owner
Phone
(508) 586-4276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X X18888 MA Primary

Addresses

Primary practice location

5 Torrey St
Brockton, MA 02301-4832

Mailing address

5 Torrey St
Brockton, MA 02301-4832
Phone (508) 586-4276

Other names 1

  • Vagenas Dental Doing business as

National Provider Directory

National Provider Directory

Locations

5 Torrey St
Brockton, MA 02301
Phone (508) 586-4276

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1982076774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014832",
            "telephone_number": "508-586-4276",
            "fax_number": "508-513-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014832",
            "telephone_number": "508-586-4276",
            "fax_number": "508-513-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILL VAGENAS, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "VAGENAS",
        "authorized_official_first_name": "VASILIOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-586-4276",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "X18888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vagenas Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.