Provider Demographics
NPI:1942218946
Name:SILVA, JOHN A (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:SILVA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:529 NANTASKET AVE
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045
Mailing Address - Country:US
Mailing Address - Phone:781-925-5100
Mailing Address - Fax:781-925-9791
Practice Address - Street 1:529 NANTASKET AVE
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045
Practice Address - Country:US
Practice Address - Phone:781-925-5100
Practice Address - Fax:781-925-9791
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA98961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0234702Medicaid