Individual provider Active NPI

Andreza Rosetti Castro

  • General Practice Dentistry
  • Fitchburg, MA
National Provider Identifier
1215173356
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DL12533 Issued in MA
Practice address
326 Nichols Road
Fitchburg, MA 01420
Phone
(978) 878-8100
Fax
(978) 878-8326
NPI assigned
Dec 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DL12533 MA Primary

Addresses

Primary practice location

326 Nichols Road
Fitchburg, MA 01420

Mailing address

326 Nichols Road
Fitchburg, MA 01420
Phone (978) 878-8100

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
I20161108000628 MA Order and Referring Only - DentistPractitioner - Dentist 1052690484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL12533MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1215173356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS ROAD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-878-8100",
            "fax_number": "978-665-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS ROAD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "ANDREZA",
        "middle_name": "ROSETTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-19",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DL12533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

Verify at the official NPI Registry.