Individual provider Active NPI

John J Pallotta, DMD

  • General Practice Dentistry
  • Lexington, MA
National Provider Identifier
1114024007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
MA11273 Issued in MA
Practice address
19 Muzzey Street Ste 302
Lexington, MA 02421
Phone
(781) 861-9597
Fax
(781) 861-3536
NPI assigned
Sep 20, 2006
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
General Practice Dentistry 1223G0001X MA11273 MA Primary

Addresses

Primary practice location

19 Muzzey Street Ste 302
Lexington, MA 02421

Mailing address

19 Muzzey Street Ste 302
Lexington, MA 02421
Phone (781) 861-9597

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
MA11273MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114024007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MUZZEY STREET STE 302",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "781-861-9597",
            "fax_number": "781-861-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MUZZEY STREET STE 302",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "781-861-9597",
            "fax_number": "781-861-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLOTTA",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "MA11273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.