Individual provider Active NPI

Mara Deborah Stein, DDS

  • Endodontics
  • Waltham, MA
National Provider Identifier
1043831829
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN1858666 Issued in MA
Practice address
271 Waverley Oaks Rd Ste 101
Waltham, MA 02452-8475
Phone
(781) 642-7500
NPI assigned
May 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN1858666 MA Primary

Addresses

Primary practice location

271 Waverley Oaks Rd Ste 101
Waltham, MA 02452-8475

Mailing address

271 Waverley Oaks Rd Ste 101
Waltham, MA 02452-8475
Phone (781) 642-7500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201205000081 MA Order and Referring Only - DentistPractitioner - Dentist 0941611420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1043831829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 WAVERLEY OAKS RD STE 101",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528475",
            "telephone_number": "781-642-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 WAVERLEY OAKS RD STE 101",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528475",
            "telephone_number": "781-642-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "MARA",
        "middle_name": "DEBORAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-03",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN1858666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.