Milita Ghassemzadeh Borguet, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS027843L Issued in PA

Practice address

110 N Essex Ave
Narberth, PA 19072-2206

Phone

(610) 664-9510

Fax

(610) 664-8468

NPI assigned

Aug 31, 2006

Last updated

Oct 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Milita G. Borguet Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 26, 2015 through Aug 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mainline Dental Arts

  • Periodontics
  • Narberth, PA
  • NPI 1326867623
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1124139647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N ESSEX AVE",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722206",
            "telephone_number": "610-664-9510",
            "fax_number": "610-664-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N ESSEX AVE",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722206",
            "telephone_number": "610-664-9510",
            "fax_number": "610-664-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASSEMZADEH BORGUET",
        "first_name": "MILITA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "18105",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS027843L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "776058",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILITA",
            "last_name": "BORGUET",
            "middle_name": "G.",
            "prefix": "MRS.",
            "credential": "D.M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Douglas E Fry, CRNP
• Sarah Jeanne Garman, PT, DPT
• Julie Garson, PSYD
• Lisa Fay Gaub, LPC
• Jeffrey S Gerland, DPM
• Peter Goldenthal, PH.D.
• Laura Gessow Goldman, M.A., CCC-SLP
• Martin B. Goldstein, D.O.
• Stacy G. Goldstein, M. A., CCC
• Stephanie C Gonzalez, OTR/L

• Periodontics in Narberth, PA
• Providers in Narberth, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.