Active NPI
Maricarmen Fernandez I
- Dentist
- Fitchburg, MA
National Provider Identifier
1215712070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL15589
- Practice address
- Nichols Rd
Fitchburg, MA 01420-1914 - Phone
- (978) 878-8110
- Fax
- (978) 627-8349
- NPI assigned
- Aug 30, 2023
- Last updated
- Aug 30, 2023
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DL15589 | MA | Primary |
Addresses
Primary practice location
Nichols Rd
Fitchburg, MA 01420-1914
Mailing address
17 High Oaks Path
Groton, MA 01450-1037
Phone (978) 735-8431
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL15589 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1215712070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 HIGH OAKS PATH",
"city": "GROTON",
"state": "MA",
"postal_code": "014501037",
"telephone_number": "978-735-8431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NICHOLS RD",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014201914",
"telephone_number": "978-878-8110",
"fax_number": "978-627-8349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MARICARMEN",
"name_suffix": "I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-30",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL15589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.