Maryam Mohammadvali Samani, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN1857760 Issued in MA

Practice address

292 Chauncy St # 150
Mansfield, MA 02048-1203

Phone

(508) 406-9592

NPI assigned

Oct 2, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681603200000",
    "number": "1013427285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAKESHORE CTR UNIT 1251",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023241084",
            "telephone_number": "617-909-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 CHAUNCY ST # 150",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481203",
            "telephone_number": "508-406-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMADVALI SAMANI",
        "first_name": "MARYAM",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2023-04-16",
        "certification_date": "2023-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "1857760",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857760",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN1857760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darlene A Menz, NP
• Grace Mimnaugh
• Mindful Life Psychotherapy LLC
• Mindgrove Health
• Christina Mitchell, CPNP-PC, PMHNP-BC
• Laura Monachino
• Bridget Monagle
• Alyssa S Monahan
• Moonphase Integrative Psychiatry & Wellness, PLLC
• Holly E Moore, M.S., ED.S

• Endodontics in Mansfield, MA
• Providers in Mansfield, MA by specialty
• Endodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.