Individual provider Active NPI

Andrew J Molak, D.M.D.

  • Dentist
  • Seekonk, MA
National Provider Identifier
1093742561
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20926 Issued in MA
Practice address
659 Fall River Ave
Seekonk, MA 02771-5620
Phone
(508) 336-4525
Fax
(508) 336-0474
NPI assigned
Jun 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20926 MA Primary

Addresses

Primary practice location

659 Fall River Ave
Seekonk, MA 02771-5620

Mailing address

659 Fall River Ave
Seekonk, MA 02771-5620
Phone (508) 336-4525

Other identifiers 2

IdentifierTypeStateIssuer
8878-1OtherRIBLUE CROSS BLUE SHIELD RI
X11972OtherMABLUE CROSS BLUE SHIELD MA

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
I20150617002078 MA Order and Referring Only - DentistPractitioner - Dentist 3476864489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20926MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew J Molak DMD Dentist Past Accepting new patients
River Ave Dental PLLC PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093742561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 FALL RIVER AVE",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027715620",
            "telephone_number": "508-336-4525",
            "fax_number": "508-336-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 FALL RIVER AVE",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027715620",
            "telephone_number": "508-336-4525",
            "fax_number": "508-336-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLAK",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD RI",
            "identifier": "8878-1",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "X11972",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seekonk, MA

Sources for this page

Verify at the official NPI Registry.