SOUTHERN MASSACHUSETTS DENTAL, P.C. (NPI# 1871917997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871917997 |
| Entity Type | Organization |
| Organization Name | SOUTHERN MASSACHUSETTS DENTAL, P.C. |
| Other Organization Name | LAKEVILLE DENTAL |
| Practice Address |
54 Main St Suite 6 Lakeville MA 02347-3621 |
| Practice Telephone | 5089236900 |
| Mailing Telephone | 5089236900 |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |
| Authorized Official Name | DR. MINH PHUONG BUI (OWNER) |
| Authorized Official Telephone | 7742139178 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakeville Dental | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SOUTHERN MASSACHUSETTS DENTAL, P.C. | 23 Ox Bow Lane, Randolph, MA 02368 |
| Street Address |
54 MAIN ST SUITE 6 |
| City | LAKEVILLE |
| State | MA |
| Zip Code | 02347-3621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710156930 | Lakeville Dental Associates, P.C. | Clinic/Center | 54 Main St, Suite 6, Lakeville, MA 02347-3621 | 2008-02-21 |
| 1962569475 | Chuong Pham | Dentist | 54 Main St, Suite 6, Lakeville, MA 02347-3621 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902424302 | Sherry Ann Szczepkowski-demoura | Nurse Practitioner | 82 Freetown Street, Lakeville, MA 02347 | 2020-07-12 |
| 1730678038 | Wagner Pt & Performance LLC | Clinic/Center | 290 Bedford St, Lakeville, MA 02347 | 2018-05-02 |
| 1275960478 | Scott Michael Jarvis | Social Worker | 5 Bells Brook Rd, Lakeville, MA 02347 | 2013-10-02 |
| 1508034240 | Nelia M. Rodelle | Technician/Technologist | 47 Fuller Shores Road, Lakeville, MA 02347 | 2008-02-15 |
| 1497951594 | Lakeville Physical Therapy Inc | Physical Therapist | 155 Millennium Cir, Suite 114, Lakeville, MA 02347 | 2007-06-25 |
| 1609901875 | Lift & Care Systems, Inc. | Durable Medical Equipment & Medical Supplies | 7 Precinct Street, Lakeville, MA 02347 | 2007-02-21 |
| 1154479582 | Stephen Givinal Gouveia | Physical Therapist | 155 Millenium Dr, Lakeville Physical Therapy Inc Suite 114, Lakeville, MA 02347 | 2007-01-08 |
| 1992802615 | George Palaiologos | Chiropractor | 66 Main Street, Lakeville, MA 02347 | 2006-09-17 |
| 1326055419 | Cameron Luree Marzelli | Psychologist | 104 Charles Eldredge Drive, Lakeville, MA 02347 | 2006-08-02 |
| 1740295617 | Paige A Leavitt-halsall | Registered Nurse | 104 Charles Eldridge Drive, Tranquil Mind & Wellness Inc, Lakeville, MA 02347 | 2006-07-29 |
| Find all providers in zip 02347 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780235747 | Glacier Lake Dental P A | Clinic/Center | 10450 185th St W Ste 500, Lakeville, MN 55044-6690 | 2019-09-21 |
| 1750861258 | Rivers Edge Dental Clinic, Pllc | Clinic/Center | 16023 Elmhurst Ln Ste 104, Lakeville, MN 55044-4791 | 2018-08-15 |
| 1144743808 | Jeffery A. Kohler, Jr., Dds Pllc | Clinic/Center | 17600 Cedar Ave, Lakeville, MN 55044-6339 | 2017-07-24 |
| 1093128225 | Marion Village Dental | Clinic/Center | 54 Main Street, Suite 6 C/o Lakeville Dental, Lakeville, MA 02347 | 2014-06-05 |
| 1205265535 | Pdg, P.a. | Clinic/Center | 17436 Kenwood Trl, Lakeville, MN 55044-9219 | 2013-11-07 |
| 1710156930 | Lakeville Dental Associates, P.C. | Clinic/Center | 54 Main St, Suite 6, Lakeville, MA 02347-3621 | 2008-02-21 |
| 1871697805 | Lakeville Dental Associates, P.a. | Clinic/Center | 20171 Icenic Trl, Lakeville, MN 55044-7708 | 2006-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265771 | Sidhu Family Dental LLC | Clinic/Center | 15 West St Ste 101, Douglas, MA 01516-2160 | 2020-11-04 |
| 1205436276 | The Nurture Frenectomy Center | Clinic/Center | 200 Elm St Ste 1, Pittsfield, MA 01201-6551 | 2020-10-29 |
| 1417557463 | Marva Khalid Dentistry PC | Clinic/Center | 105 Chestnut St Ste 25, Needham, MA 02492-2520 | 2020-10-29 |
| 1417555855 | Gardner Smiles Pllc | Clinic/Center | 356 Timpany Blvd, Gardner, MA 01440-5200 | 2020-10-16 |
| 1326646399 | Restoration Smiles, P.C. | Clinic/Center | 2 Coolidge St Ste 202, Hudson, MA 01749-1459 | 2020-10-13 |
| 1295333573 | Brian P. Ganley, Dmd, PC | Clinic/Center | 134 Main St Unit 1c, Groton, MA 01450-1375 | 2020-10-09 |
| 1619583168 | Newton Wellesley Dental Group LLC | Clinic/Center | 447 Centre Street, Same, Newton, MA 02458 | 2020-09-21 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1831703099 | Beacon Dental Health PC | Clinic/Center | 80 Washington St Bldg B, Norwell, MA 02061-1740 | 2020-09-04 |
| 1487267282 | Shoe City Family Dental PC | Clinic/Center | 103 Merrimack St, Haverhill, MA 01830-6208 | 2020-08-31 |
| 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.