Individual provider Active NPI

Constantinos Laskarides, DMD, DDS, PHARMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
National Provider Identifier
1215138672
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN1855296 Issued in MA
Practice address
1 Kneeland St RM 503
Boston, MA 02111-1527
Phone
(617) 636-6648
Fax
(617) 636-6809
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN1855296 MA Primary

Addresses

Primary practice location

1 Kneeland St RM 503
Boston, MA 02111-1527

Mailing address

1 Kneeland St RM 503
Boston, MA 02111-1527
Phone (617) 636-6648

Other practice location 1

9A Dr Osman Babson Rd
Gloucester, MA 01930-1812
Phone (978) 281-3772

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
I20110308000779 MA Practitioner - Oral Surgery 4183806409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Tufts University School of Dental Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 A Dr Osman Babson Rd
Gloucester, MA 01930-1812
Phone (978) 281-3772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Martin E. Cutler, MD PC CurrentSince Aug 17, 2019 Accepting new patients
Soheil Samiei DMD PC Oral and Maxillofacial Surgery CurrentSince Aug 17, 2019 Accepting new patients

Locations

9A Dr Osman Babson Rd
Gloucester, MA 01930
Phone (978) 281-3772

Interoperability endpoints

  • Direct secure messaging: claskarides29445@tuftsmedicine.direct-ci.com

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1215138672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST RM 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6648",
            "fax_number": "617-636-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST RM 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6648",
            "fax_number": "617-636-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9A Dr Osman Babson Rd",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "MA",
            "postal_code": "019301812",
            "country_code": "US",
            "telephone_number": "978-281-3772",
            "fax_number": "978-281-0316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASKARIDES",
        "first_name": "CONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "DMD, DDS, PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1855296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.