Drew M Mittelman, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12569 Issued in MA

Practice address

1 Lyons St
Dedham, MA 02026-5599

Phone

(781) 329-1400

Fax

(781) 278-5667

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265439657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9120",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020279120",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELMAN",
        "first_name": "DREW",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "12569",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BLUE",
            "identifier": "X04083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "X04083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PPO",
            "identifier": "X04083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD/PILGRIM",
            "identifier": "X04083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM POS",
            "identifier": "X04083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0016778",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• R Matthew Miner, D.D.S.
• Sara S Minias
• Jennifer A Mirabella, LICSW
• Andrea Mischke, M.S. CCC-SLP
• Asiamonet Mitchell
• Shahab Mohiuddin, M.D.
• Miguel Enrique Montesino Jr., M.D.
• Mary Kathryn Montgomery
• Sarah Marie Montgomery, MA
• Linda Marie Mooney, CPNP

• General Practice Dentistry in Dedham, MA
• Providers in Dedham, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.

Verify at the official NPI Registry.