DR. ROBERT J MOREAU SR. (NPI# 1225160138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225160138 |
| Entity Type | Individual |
| Full Name | DR. ROBERT J MOREAU SR. |
| Credential | D.M.D. |
| Practice Address |
905 S Main St Suite 102 Mansfield MA 02048-3149 |
| Practice Telephone | 5083373307 |
| Practice Fax Number | 5083373317 |
| Mailing Telephone | 5083373307 |
| Mailing Fax Number | 5083373317 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2016-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
18512 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | X12178 | 01 |
| Street Address |
905 S MAIN ST SUITE 102 |
| City | MANSFIELD |
| State | MA |
| Zip Code | 02048-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386293181 | Taylor Dabney | Specialist/Technologist | 1912 Francis Ave, Station Pointe Apt, Mansfield, MA 02048 | 2019-09-05 |
| 1720643935 | Emily Cecilia Pavidis | Doula | 1705 West Street, Mansfield, MA 02048 | 2019-05-02 |
| 1942784244 | Mary Rego Perry | Social Worker | 19 North White Pine Lane, Mansfield, MA 02048 | 2018-09-21 |
| 1306341078 | Danielle Haradon | Student in an Organized Health Care Education/Training Program | 42 Fieldstone Drve, Mansfield, MA 02048 | 2018-03-26 |
| 1750882353 | Mansfield Physical Therapy & Wellness LLC | Physical Therapist | 200 Chauncy St Ste 4, Mansfield, MA 02048 | 2018-02-28 |
| 1548671498 | Angela Silva | Developmental Therapist | 73 Elyse Rd, Mansfield, MA 02048 | 2014-05-14 |
| 1700123049 | Christy Kelly Ciccariello | Pediatrics | 4 Samoset Way, Mansfield, MA 02048 | 2013-01-07 |
| 1659620292 | Deirdre J Manning | Physical Therapist | 31 Oxford Road, Mansfield, MA 02048 | 2012-08-29 |
| 1043514706 | Carpen, Inc. | Health Maintenance Organization | 287 School St., Mansfield, MA 02048 | 2011-01-10 |
| 1295062545 | Theresa Melchionna Rhein | Social Worker | 450 Chauncy Street, Mansfield, MA 02048 | 2009-11-06 |
| Find all providers in zip 02048 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679014567 | Corey Menou | Dentist | 1830 E Broad St Ste 104, Mansfield, TX 76063-9161 | 2017-03-13 |
| 1518353184 | Elias E Chahine | Dentist | 1756 Broad Park Cir S #100, Mansfield, TX 76063 | 2015-04-10 |
| 1508133224 | Pediatric Dentristry of Mansfield,pllc | Dentist | 1830 E Broad St, Ste104, Mansfield, TX 76063-9162 | 2011-11-23 |
| 1396901922 | Daniel E Wright | Dentist | 1830 E. Broad St., Suite 104, Mansfield, TX 76063-2874 | 2008-08-04 |
| 1811106909 | Heather Ann Gregg | Dentist | 245 Sterkle Blvd, Suite 101, Mansfield, OH 44907 | 2007-05-22 |
| 1972649143 | Deborah C. Sullivan | Dentist | 1200 U.S. Hwy 287 North, Suite 102, Mansfield, TX 76063 | 2007-01-29 |
| 1699853051 | Timothy J Iten | Dentist | 1 Marion Ave Ste 201, Mansfield, OH 44903-7905 | 2006-11-02 |
| 1487740114 | Jackson Cockley | Dentist | 1145 Aspira Ct, Mansfield, OH 44906-4125 | 2006-10-04 |
| 1356328041 | Randolph W Hamilton IIi | Dentist | 1759 Broad Park Cir S, Mansfield, TX 76063 | 2005-12-23 |
| 1285921825 | Blane Reynolds Hamilton | Dentist | 1759 Broad Park Cir S, Ste 205, Mansfield, TX 76063-7833 | 2011-07-04 |
| Find all providers in MANSFIELD | ||||
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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.