Joanne Marian, DMD
Individual provider Active NPI General Practice Dentistry · Bolton, MA
NPI 1073623930 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1073623930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 17297 (MA)
- Practice address
- 737 Main St
Bolton, MA 01740 - Phone
- (978) 779-6223
- Fax
- (978) 779-6479
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150518001700 | MA | Order and Referring Only - Dentist |
3476873332 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN12354 | FL | MD | General Practice Dentistry |
| 17297 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bolton Famiy Dental, LLP | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17297 | MA | Yes |
| General Practice Dentistry | 1223G0001X | DN12354 | FL |
Addresses
Primary practice location
737 Main St
Bolton, MA 01740
Mailing address
737 Main St
PO Box 309
Bolton, MA 01740
Phone (978) 779-6223
Other providers in Bolton, MA
- Gloria E. Pierce, LMHC LLC
- Jennifer Laura Habeeb
- Victoria A Haskell
- Emilie Caitlin Larrivee
- Marianela Lavena
- Pamela R Miller
- Nashoba Regional School District
- Diane Lynn Nesman
- Lisa B Noble
- Hannah Elizabeth Noyes
All providers in Bolton, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.