Active NPI
Laura Simon, D.M.D.
- Public Health Dentistry
- Arlington, MA
National Provider Identifier
1174649891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 21594
- Practice address
- 19 Chestnut St
Arlington, MA 02474-1225 - Phone
- (781) 643-2344
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 21594 | MA | Primary |
Addresses
Primary practice location
19 Chestnut St
Arlington, MA 02474-1225
Mailing address
45 Commonwealth Ave
Apt. 9
Boston, MA 02116-2327
Phone (617) 530-0258
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 |
|---|---|---|---|---|
| I20160601001069 | MA | Order and Referring Only - Dentist | 9830489095 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smart Dental Inc. | Past | Accepting new patients | |
| Joseph Maniscalco DDS PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Arlington, MA
- NPI 1669618591
-
- General Practice Dentistry
- Arlington, MA
- NPI 1336150697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174649891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 COMMONWEALTH AVE",
"address_2": "APT. 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "021162327",
"telephone_number": "617-530-0258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 CHESTNUT ST",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024741225",
"telephone_number": "781-643-2344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "LAURA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "MA",
"license": "21594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arlington, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.