1. Home
  2. Directory
  3. Massachusetts
  4. Southbridge
  5. Dentist
  6. NPI Profile

SOUTHBRIDGE DENTAL LLC
NPI 1184284549
Dentist - General Practice in Southbridge, MA

Active since June 18, 2019
305 MAIN ST, SOUTHBRIDGE, MA 01550(508) 765-0880 Get Directions Write a Review

NPPES record last updated: September 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 20, 2021, Jun 18, 2019 (2 updates tracked since 2019).

About Southbridge Dental Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHBRIDGE DENTAL LLC (NPI 1184284549) is a healthcare organization registered as a general practice in Southbridge, Massachusetts and active in the NPI registry since June 2019. The organization lists Suman Reddivari, Member, as its authorized official.

NPPES Registry Identity

NPI1184284549
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHBRIDGE DENTAL LLC
Location Address305 MAIN STSouthbridge, MA 01550-3726
Mailing Address305 Main StSouthbridge, MA 01550-3726 · (508) 765-0880
Phone(508) 765-0880
Organization SubpartNo
Authorized OfficialSuman ReddivariMember · (781) 552-1567
Enumeration DateJune 18, 2019
Last NPPES UpdateSeptember 20, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2021
✔ NPI 1184284549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
305 MAIN ST, Southbridge, MA 01550
Open in Google Maps ↗

Other Identifiers 1

Medicaid3071228NH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ARPIT RAJESHKUMAR MEHTA DMD
Dentist
305 MAIN ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 765-0880
ALLEN RUBIN DMD PC
Dentist
305 MAIN ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 765-0040
MY DENTAL SOUTHBRIDGE PLLC
Clinic/Center (Dental)
305 MAIN ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 765-0880
DR. ALLEN JAY RUBIN DMD
Dentist (General Practice)
305 MAIN ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 765-0880
KINNAR SHAH, DMD, PC
Dentist (General Practice)
305 MAIN ST
SOUTHBRIDGE, MA 01550
Worcester County (508) 765-0880

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southbridge Dental LLC's NPI number?

The NPI number for Southbridge Dental LLC is 1184284549. It was assigned to this organization in the NPPES registry on June 18, 2019.

Where is Southbridge Dental LLC located?

Southbridge Dental LLC is located at 305 Main St, Southbridge, MA 01550. The listed phone number is (508) 765-0880.

What is Southbridge Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Southbridge Dental LLC was last updated on September 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.