Lisa Lanzillotti Peterson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

10120 Issued in MA

Practice address

116 Main St
Millbury, MA 01527-2021

Phone

(508) 865-2622

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Lanzillotti Former name

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Millbury Family Dentistry, P.C.

  • Dentist
  • Millbury, MA
  • NPI 1720369853
  NPD (past)

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1063677250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272021",
            "telephone_number": "508-865-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MAIN ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272021",
            "telephone_number": "508-865-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LISA",
        "middle_name": "LANZILLOTTI",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "10120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LANZILLOTTI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheila Marie Pagan
• Carrie Jean Palmer, R.N.
• Passmore Luv
• Ronaldo D Pereira
• Stella Persimei
• Olivia Michelle Peterson, MSW
• Eric George Piascik, D.M.D.
• Melissa Pomeroy, PT
• Vicki Portais, PT
• Ryan Poulin

• Dentist in Millbury, MA
• Providers in Millbury, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.