Active NPI
Marilyn S Lyons, DMD, MMS
- Endodontics
- Londonderry, NH
National Provider Identifier
1104869809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 1844
- Practice address
- 77 Gilcreast Road
#2000
Londonderry, NH 03053 - Phone
- (603) 425-2307
- Fax
- (603) 437-8190
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 1844 | NH | Primary |
| Endodontics | 1223E0200X | 13970 | MA |
Addresses
Primary practice location
77 Gilcreast Road
#2000
Londonderry, NH 03053
Mailing address
77 Gilcreast Road, #2000
Londonderry, NH 03053
Phone (603) 425-2307
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X12135 | Other | MA | BC/BS OF MA PROVIDER # |
| X12134 | Other | NH | BC/BS OF MA PROVIDER # |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150410001015 | MA | Order and Referring Only - Dentist | 4082932678 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1844 | NH | MD | Clinical Social Worker |
| 13970 | MA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steinert Endodontic Associates | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Methuen, MA
- NPI 1548272131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1104869809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 GILCREAST ROAD, #2000",
"city": "LONDONDERRY",
"state": "NH",
"postal_code": "03053",
"telephone_number": "603-425-2307",
"fax_number": "603-437-8190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 GILCREAST ROAD",
"address_2": "#2000",
"city": "LONDONDERRY",
"state": "NH",
"postal_code": "03053",
"telephone_number": "603-425-2307",
"fax_number": "603-437-8190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "MARILYN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD, MMS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-13",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NH",
"license": "1844",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "13970",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MA PROVIDER #",
"identifier": "X12135",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MA PROVIDER #",
"identifier": "X12134",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Londonderry, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.