MARK DOHERTY


Address: 1353 Dorchester Ave, Dorchester, MA 02122-2932
Phone: 6172883230

MARK DOHERTY (NPI# 1285696674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285696674
Entity Type Individual
Full Name MARK DOHERTY
Credential MD
Practice Address 1353 Dorchester Ave
Dorchester
MA 02122-2932
Mailing Address 12 Colleen Dr
Lakeville
MA 02347-1663
Practice Telephone 6172883230
Practice Fax Number 6178254972
Mailing Telephone 5089464945
Enumeration Date 2006-04-03
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204E00000X Oral & Maxillofacial Surgery 12683 MA Allopathic & Osteopathic Physicians

Other Providers MARK DOHERTY

NPI Name Taxonomy Address Enumeration
1669823043 Mark Doherty Behavioral Analyst 7 Bishop St, Framingham, MA 01702-8323 2016-06-27
1194818872 Mark E Doherty Dentist 1155 Purchase St., New Bedford, MA 02740 2006-10-02
1952400079 Mark Robert Doherty Dentist 26 Surfside Rd, Pryor, OK 74361-3306 2006-09-22
1801892260 Mark J. Doherty Dermatology 1151 Ellis St Ste 202, Bellingham, WA 98225-5203 2005-06-21
1144862822 Mark Doherty Massage Therapist 623 Broadway, Massapequa, NY 11758-5027 2019-10-14
1497038145 Mark Thomas Doherty Pharmacist 120 E Main St, Streator, IL 61364-2901 2011-09-20
1467423871 Mark Gerard Doherty Obstetrics & Gynecology 1625 N George Mason Dr, Suite 475, Arlington, VA 22205-3683 2006-02-01

Office Location

Street Address 1353 DORCHESTER AVE
City DORCHESTER
State MA
Zip Code 02122-2932

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750340410 Holly L Goodale Specialist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2006-03-21
1841891728 Christopher White Physical Therapist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2020-11-05
1790393767 Daniel Rabinowicz Physical Therapist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2020-07-16
1902432826 Dorreen Danesh Internal Medicine 1353 Dorchester Ave, Dorchester, MA 02122-2932 2020-03-23
1174179857 Yue Yu Optometrist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2019-08-17
1316410376 Rachel Wasserman Nurse Practitioner 1353 Dorchester Ave, Dorchester, MA 02122-2932 2019-01-02
1114402807 Dorchester House Multi Service Center Clinic/Center 1353 Dorchester Ave, Dorchester, MA 02122-2932 2018-09-27
1861988503 Sirena Huang Optometrist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2018-07-05
1336634526 Stephen Cronk Dentist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2018-06-29
1356842934 Kyle Andrew Bertram Pharmacist 1353 Dorchester Ave, Dorchester, MA 02122-2932 2018-02-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033720875 Joey Mark Nguyen Pharmacist 747 Gallivan Blvd, Dorchester, MA 02122 2020-08-14
1518575240 Hamilton Pharmacy LLC Pharmacy 246 Bowdoin St, Dorchester, MA 02122 2020-07-20
1336789528 Katheline Leconte Social Worker 230 Bowdoin Street, Dorchester, MA 02122 2020-01-15
1700374725 Renee Ahern Registered Nurse 398 Neponset Ave., Dorchester, MA 02122 2018-04-25
1861902371 Bridget Mary Walsh Specialist/Technologist 519 Ashmont St, Dorchester, MA 02122 2017-10-10
1649798133 Roosevelt Lewis IIi Registered Nurse 1486 Dorchester Ave Ste 206, Boston, MA 02122 2017-09-05
1811427404 Hanh Nguyen Counselor 50 Redfield St, Suite 300, Dorchester, MA 02122 2017-06-15
1669902474 Thuy T Nguyen Counselor 415 Neponset Avenue, Dorchester, MA 02122 2017-06-14
1093262651 David Scot Rapaport Counselor 1452 Dorchester Avenue, Fcbl-4, Boston, MA 02122 2016-09-01
1104372960 Kevin Lyn Sisson Student in an Organized Health Care Education/Training Program 417 Neponset Ave, Boston, MA 02122 2016-08-31
Find all providers in zip 02122

Taxonomy Information

Taxonomy Code 204E00000X
Grouping Allopathic & Osteopathic Physicians
Classification Oral & Maxillofacial Surgery

Taxonomy Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093984080 Dario Enrique Gonzalez Oral & Maxillofacial Surgery 637 Washington Street, Dorchester, MA 02124 2008-02-25

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1518452705 Yisi D Ji Oral & Maxillofacial Surgery 165 Cambridge St Ste 401, Mgh Dental Group, Boston, MA 02114-2750 2018-06-29
1013219476 Karim E . Berty Dmd Md PC Oral & Maxillofacial Surgery 100 Amesbury St Ste 112, Lawrence, MA 01840-1321 2010-11-17
1457587065 Zachary Scott Peacock Oral & Maxillofacial Surgery 55 Fruit Street, Warren 1201, Boston, MA 02114-2621 2009-06-10
1851580708 Basim Jamal Oral & Maxillofacial Surgery 820 Harrison Ave, Fgh Building 4th Floor, Boston, MA 02118-2905 2007-10-16
1780875336 Paul E Tesone Dds Oral & Maxillofacial Surgery One Centre Street, Malden, MA 02148 2007-08-08
1477679157 Facial & Oral Surgery, LLC. Oral & Maxillofacial Surgery 17 N Washington St, North Attleboro, MA 02760-1605 2007-03-22
1003954504 Timothy S Colton Dds PC Oral & Maxillofacial Surgery 164 Washington St, Suite 102, Norwell, MA 02061 2007-02-05
1609970268 Brett Culver Denhart Oral & Maxillofacial Surgery 1066 Granby Road, Chicopee, MA 01020 2006-09-12
1265447965 Edward T Lahey IIi Oral & Maxillofacial Surgery 15 Parkman St Wac 230, Oral & Maxillofacial Surgery, Boston, MA 02114 2006-07-30
1558382572 Connecticut Valley Oral Surgery Associates, PC Oral & Maxillofacial Surgery 243 King St, Suite 101, Northampton, MA 01060-2451 2006-07-23
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Competitor

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City DORCHESTER
Zip Code 02122

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Dataset Information

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.

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