Lynn H. Duboff, DMD, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

LYNN H. DUBOFF, DMD, PLLC

Doing business as

Complete Health Periodontics

Practice address

72 Allen St
Rutland, VT 05701-4568

Phone

(802) 779-6137

NPI assigned

Sep 21, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Lynn Harasty Duboff, DMD

Title

Dr.

Phone

(802) 779-6137

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Complete Health Periodontics Doing business as

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

{
    "created_epoch": "1569024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569024000000",
    "number": "1164073136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 HAWLEY LN",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057018979",
            "telephone_number": "802-855-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014568",
            "telephone_number": "802-779-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN H. DUBOFF, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-21",
        "last_updated": "2019-09-21",
        "status": "A",
        "authorized_official_last_name": "DUBOFF",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "HARASTY",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "802-779-6137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790969582",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Health Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joseph Matthew Macura
• Craig Edward Maddox
• Mary Ruth Maglione, MACP,LADC
• Cesar H Magsino Jr., MD
• Peter Michael Mahar, MS, LCMHC

• Periodontics in Rutland, VT
• Providers in Rutland, VT by specialty
• Periodontics in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2019; 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.