Individual provider Active NPI

Larissa Heidemann Paganini, DMD

  • General Practice Dentistry
  • East Boston, MA
National Provider Identifier
1104443936
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1858710 Issued in MA
Practice address
20 Maverick SQ
East Boston, MA 02128-2335
Phone
(617) 569-5800
Fax
(617) 568-4090
NPI assigned
Jun 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1858710 MA Primary

Addresses

Primary practice location

20 Maverick SQ
East Boston, MA 02128-2335

Mailing address

10 Gove St
East Boston, MA 02128-1920
Phone (617) 568-4782

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

LicenseStateTypeSpecialty
DN1858710MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
My Dental Somerville General Practice CurrentSince Jun 12, 2022 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

128 Broadway
Somerville, MA 02145
Phone (617) 669-5588

Interoperability endpoints

  • Direct secure messaging: lpaganini364687@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1104443936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-568-4782",
            "fax_number": "617-568-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MAVERICK SQ",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021282335",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDEMANN PAGANINI",
        "first_name": "LARISSA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.