Michael George Broutsas, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12159 Issued in MA

Practice address

54 Winthrop St
Taunton, MA 02780

Phone

(508) 824-7023

Fax

(508) 823-0757

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Michael G. Broutsas D.D.S.,P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Taunton, MA
  • NPI 1205146248
  NPD (past) Authorized official
• Morton Hospital, a Steward Family Hospital, Inc.

  • General Acute Care Hospital
  • Taunton, MA
  • NPI 1073021986
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982612362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 WINTHROP ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "02780",
            "telephone_number": "508-824-7023",
            "fax_number": "508-823-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 WINTHROP ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "02780",
            "telephone_number": "508-824-7023",
            "fax_number": "508-823-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUTSAS",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "12159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bristol-Plymouth Regional Technical School
• Jennifer Brito
• Brockton Spine and Rehab
• Sarah Brodeur, M.S.W
• Mary Ellen Bronner, LCSW
• Courtnie Brown, BA
• Daniel Brown
• Danielle Lynne Brown, COTA
• Deborah Eileen Brown, MSW
• Emily Lesley Brown, LMHC

• Oral and Maxillofacial Surgery (Dentist) in Taunton, MA
• Providers in Taunton, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.