Active NPI
Stacey Janill Perez
- Dentist
- Revere, MA
National Provider Identifier
1023972189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL101303
- Practice address
- 93 Ward St Unit 513
Revere, MA 02151-1346 - Phone
- (347) 475-2869
- NPI assigned
- Dec 12, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DL101303 | MA | Primary |
Addresses
Primary practice location
93 Ward St Unit 513
Revere, MA 02151-1346
Mailing address
93 Ward St
Revere, MA 02151-1335
Phone (978) 532-4903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL101303 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1023972189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 WARD ST",
"city": "REVERE",
"state": "MA",
"postal_code": "021511335",
"telephone_number": "978-532-4903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 WARD ST UNIT 513",
"city": "REVERE",
"state": "MA",
"postal_code": "021511346",
"telephone_number": "347-475-2869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "STACEY",
"middle_name": "JANILL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-12",
"last_updated": "2025-12-12",
"certification_date": "2025-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL101303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.