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RICHARD J SORBERA DDS SHILBY D MALOUF DDS INC NPI 1164597217


NPI Information

NPI: 1164597217
Provider Name: RICHARD J SORBERA DDS SHILBY D MALOUF DDS INC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
366 BROADWAY
SOMERVILLE, MA
ZIP 01245
Phone: (617) 628-8000
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RICHARD J SORBERA DDS SHILBY D MALOUF DDS INC is an oral and maxillofacial surgery dentist in Somerville, MA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. RICHARD J SORBERA DDS SHILBY D MALOUF DDS INC NPI is 1164597217. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

366 BROADWAY
SOMERVILLE, MA
ZIP 01245-812
Phone: (617) 628-8000
Fax: (617) 628-2370

The provider's authorized official is Shilby D Malouf .
The authorized official title is Vice President and has the following contact phone number (617) 628-8000.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery9458MASSACHUSETTSNo
21223S0112XDentistOral and Maxillofacial Surgery9637MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10223573MEDICAIDMASSACHUSETTS
2X03044OTHERMASSACHUSETTSRS
3X03159OTHERMASSACHUSETTSRS
40202061MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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