Individual provider Active NPI

Laura Simon, D.M.D.

  • Public Health Dentistry
  • Arlington, MA
National Provider Identifier
1174649891
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
21594 Issued in MA
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

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
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601001069 MA Order and Referring Only - DentistPractitioner - Dentist 9830489095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.