Western Mass Periodontics PC
Dentist, Periodontics in Agawam, Massachusetts
1457709180- Practice location
- 158 Main St, Agawam, MA 01001
- Phone
- 413-786-2341
- Fax
- —
- Last updated
- January 18, 2022
Western Mass Periodontics PC is a healthcare organization based in Agawam, MA. Western Mass Periodontics PC practices in Agawam, MA. The NPI Number for Western Mass Periodontics PC is 1457709180 and holds a License No. 19671 (MA). The current practice location address for Western Mass Periodontics PC is 158 Main St, Agawam, MA 01001 and can be reached out via phone at 413-786-2341.
Provider Profile Details
- NPI Number
- 1457709180
- Provider Name
- Western Mass Periodontics PC
- Provider Entity Type
- Organization
- Address
- 158 Main St, Agawam, MA 01001
- Phone Number
- 413-786-2341
- Primary Taxonomy
- Dentist, Periodontics · 1223P0300X
- Organization Subpart
- Yes
- Parent Organization
- Western Mass Periodontics PC
- Authorized Official
- Leah Ann Maylott · Credentialing Administrator · 860-874-8198
- Other Names
- Nobel Perio (Former Legal Business Name)
- Provider Enumeration Date
- June 3, 2016
- Last Update Date
- January 18, 2022
- Certification Date
- January 11, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 158 Main St
Agawam, MA 01001 - City
- Agawam
- State
- Massachusetts
- Zip
- 01001
- Phone Number
- 413-786-2341
Provider Business Mailing Address Details
- Address
- 65 Elm St
Worcester, MA 01609-2547 - City
- Worcester
- State
- MA
- Zip
- 01609-2547
- Phone Number
- 860-874-8198
License Information
- License Number
- 19671
- License State
- MA
- Taxonomy
- Dentist, Periodontics · 1223P0300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentist, Periodontics providers near Agawam, MA
View all Dentist, Periodontics providers in Agawam →Frequently Asked Questions
What is the NPI number of Western Mass Periodontics PC?
The NPI number of Western Mass Periodontics PC is 1457709180. It was assigned on June 3, 2016 and is currently active in the NPPES registry.
What is the specialty of Western Mass Periodontics PC?
Western Mass Periodontics PC is registered under the primary taxonomy Dentist, Periodontics (code 1223P0300X), licensed in MA under license number 19671.
Where does Western Mass Periodontics PC practice?
The practice location is 158 Main St, Agawam, MA 01001. The office can be reached at 413-786-2341 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1457709180 directly on the NPPES registry website.