Rachelle Abou-Ezzi, D.M.D
Individual provider Active NPI General Practice Dentistry · North Andover, MA
NPI 1164579389 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164579389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 18765 (MA)
- Practice address
- 555 Turnpike St
# 55
North Andover, MA 01845-5923 - Phone
- (978) 685-5562
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective May 20, 2016 through May 20, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18765 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E Z Dental, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18765 | MA | Yes |
Addresses
Primary practice location
555 Turnpike St
# 55
North Andover, MA 01845-5923
Mailing address
555 Turnpike St
# 55
North Andover, MA 01845-5923
Phone (978) 685-5562
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0281646 | Medicaid | MA |
Other providers in North Andover, MA
- Aaron Pollock, PC
- Abc Pediatrics
- Abc Speech and Language Services, LLC
- Dorina R Abdulah
- David Abou-Ezzi
- Access Primary Care Inc
- Acelleron Medical Products LLC
- Acme Therapy Holdings Inc
- Stephen Junior Atanga Adagwuni
- Alayna Adams
All providers in North Andover, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.