NPIMap

Organization Active NPI

North Boston Oral & Facial Surgery Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Amesbury, MA
National Provider Identifier
1992120463
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
NORTH BOSTON ORAL & FACIAL SURGERY INC
Practice address
242 Main St
Amesbury, MA 01913-3721
Phone
(617) 233-6786
NPI assigned
Feb 20, 2014
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Jeff Blaeser
Title
Practice Admin
Phone
(978) 531-1450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

242 Main St
Amesbury, MA 01913-3721

Mailing address

242 Main St
Amesbury, MA 01913-3721
Phone (617) 233-6786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140819000562 MA Part B Supplier - Clinic/Group Practice 0941427785 Receives reassigned benefits from 3 practitioners
Practice locations: Amesbury, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1992120463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MAIN ST",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019133721",
            "telephone_number": "617-233-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MAIN ST",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019133721",
            "telephone_number": "617-233-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BOSTON ORAL & FACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "BLAESER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "978-531-1450"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amesbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.