ELITE DENTAL GROUP PC (NPI# 1811352537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811352537 |
| Entity Type | Organization |
| Organization Name | ELITE DENTAL GROUP PC |
| Practice Address |
76 South St Brockton MA 02301-6841 |
| Practice Telephone | 5085831772 |
| Practice Fax Number | 5085605616 |
| Mailing Telephone | 5085831772 |
| Mailing Fax Number | 5085605616 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2015-12-22 |
| Authorized Official Name | DR. SATHISH L GOBICHETTYPALAYAM (PRESIDENT) |
| Authorized Official Telephone | 7816987136 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22099 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043645336 | Elite Dental Group PC | Clinic/Center | 523 Foundry St, North Easton, MA 02356-2736 | 2013-09-05 |
| Street Address |
76 SOUTH ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-6841 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982076774 | Bill Vagenas, Dmd, LLC | Dentist | 5 Torrey St, Brockton, MA 02301-4832 | 2015-10-20 |
| 1598193971 | A-one Dental P.C. | Dentist | 772 Belmont St, Brockton, MA 02301-5603 | 2013-10-23 |
| 1558622753 | Jay Muruga Theva | Dentist | 200 Westgate Dr Ste 119, Brockton, MA 02301-1810 | 2012-06-04 |
| 1447444344 | Srijan Mehta | Dentist | 698 Crescent Street, Brockton, MA 02302 | 2007-09-04 |
| 1346367158 | Robert Freccero | Dentist | 79 Byron Ave, Brockton, MA 02301-4201 | 2007-03-25 |
| 1285767376 | Robert Jeffrey Tuck | Dentist | 567 Pleasant St, Brockton, MA 02301-2507 | 2007-03-14 |
| 1699810812 | Vasilios Vagenas | Dentist | 5 Torrey Street, Brockton, MA 02301 | 2007-02-21 |
| 1215074661 | Rajeev Trikha | Dentist | 698 Crescent St, Brockton, MA 02302-3360 | 2007-02-01 |
| 1568512655 | Full Service Dental Health P.C. | Dentist | 200 Westgate Dr Ste 2, Brockton, MA 02301-1810 | 2007-01-11 |
| 1053487561 | Drs Celli and Fields | Dentist | 185 Belmont Street, Brockton, MA 02301-5196 | 2006-11-27 |
| Find all providers in BROCKTON | ||||
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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.