MARK DOHERTY (NPI# 1285696674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgery | 12683 | MA | Allopathic & Osteopathic Physicians |
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 |
Street Address |
1353 DORCHESTER AVE |
City | DORCHESTER |
State | MA |
Zip Code | 02122-2932 |
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 |
Find all providers in the same location |
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 Code | 204E00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Oral & Maxillofacial Surgery |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093984080 | Dario Enrique Gonzalez | Oral & Maxillofacial Surgery | 637 Washington Street, Dorchester, MA 02124 | 2008-02-25 |
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 |
Find all providers with the same taxonomy |
City | DORCHESTER |
Zip Code | 02122 |
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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.