Provider Demographics
NPI:1013182740
Name:MCADAMS, TIFFANY ALEXANDRIA (DMD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ALEXANDRIA
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ALEXANDRIA
Other - Last Name:MCADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:16 SNOW RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050
Mailing Address - Country:US
Mailing Address - Phone:781-536-4051
Mailing Address - Fax:781-536-4026
Practice Address - Street 1:16 SNOW RD
Practice Address - Street 2:ALL SMILES FAMILY DENTISTRY PC
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050
Practice Address - Country:US
Practice Address - Phone:781-536-4051
Practice Address - Fax:781-536-4026
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN22095122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110079373AMedicaid