SOUTHEASTERN ORAL & MAXILLOFACIAL SURGEONS PC (NPI# 1225115470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225115470 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN ORAL & MAXILLOFACIAL SURGEONS PC |
| Practice Address |
951 North Main Street Brockton MA 02301 |
| Practice Telephone | 5085880200 |
| Practice Fax Number | 5085836156 |
| Mailing Telephone | 5085880200 |
| Mailing Fax Number | 5085836156 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN F COYNE (PRESIDENT) |
| Authorized Official Telephone | 5085880200 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
18127 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | X20040 | 05 |
| Street Address |
951 NORTH MAIN STREET |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750458451 | Oral and Maxillofacial Surgery, Inc. | Dentist | 830 Oak St, Suite 101w, Brockton, MA 02301-1168 | 2006-11-29 |
| 1225107154 | Jeffrey R. Parsons | Dentist | 830 Oak St, Suite 101w, Brockton, MA 02301-1168 | 2006-11-07 |
| 1548339476 | L. Michael Juvet | Dentist | 830 Oak St, Suite 101w, Brockton, MA 02301-1168 | 2006-11-07 |
| 1538132956 | Richard J Catrambone | Dentist | 830 Oak St, Suite 101w, Brockton, MA 02301-1168 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114573508 | Newton Dentistry PC | Dentist | 73 Lexington Street, Suite 204, Newton, MA 02466 | 2019-08-13 |
| 1700432143 | Middleboro Oral Surgeons, PC | Dentist | 47 Bedford St Unit 3, Middleboro, MA 02346-1047 | 2019-08-12 |
| 1508420621 | Nantucket Oral Surgery Pllc | Dentist | 19 1/2 Surfside Drive, Nantucket, MA 02554 | 2019-04-24 |
| 1750844080 | C.m.f.-cranio-maxillofacial Surgery Associates | Dentist | 366 Broadway Ste 100, Somerville, MA 02145-2812 | 2019-04-12 |
| 1669938130 | Milagros Serrano Dds, PC | Dentist | 1842 Beacon St Ste 303, Brookline, MA 02445-1922 | 2019-02-20 |
| 1669960027 | New England Family Dentistry,pc | Dentist | 366 Cooley St, Springfield, MA 01128-1144 | 2018-05-01 |
| 1528592029 | Jaegak Kim | Dentist | 850 Harrison Ave Fl 6, Boston, MA 02118-4001 | 2017-04-12 |
| 1609322452 | Lowell Oral Surgery Associates, Inc | Dentist | 26 North Rd, 2nd Floor, Chelmsford, MA 01824-2722 | 2016-08-31 |
| 1295189280 | Jonathan Bishop | Dentist | 208 Main St Ste 116, Milford, MA 01757-2502 | 2016-04-16 |
| 1790149987 | Capeside Oral&facial Surgery, Inc. | Dentist | 362 Gifford St, Falmouth, MA 02540-2912 | 2016-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.