Fawn Rosenberg, DMD, FAGD

Primary specialty

DentistTaxonomy code 122300000X

License

16173 Issued in MA

Practice address

922 Waltham Street
Suite 202
Lexington, MA 02421

Phone

(781) 861-6008

Fax

(781) 240-0264

NPI assigned

Jan 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1265779581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 WALTHAM STREET",
            "address_2": "SUITE 202",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "781-861-6008",
            "fax_number": "781-240-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 WALTHAM STREET",
            "address_2": "SUITE 202",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02421",
            "telephone_number": "781-861-6008",
            "fax_number": "781-240-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "FAWN",
        "name_prefix": "Dr.",
        "credential": "DMD, FAGD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "16173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Romero
• Rose L. Wang, DMD, LLC
• Judson Braxton Rose
• Stacie Rose, PMHNP
• Elizabeth Rosen, M.D.
• Seth Ian Rosenthal, MD
• Tina Marie Rossino, PTA
• Howard Rossman, PH.D.
• Ellen A Roth, M.S.W.
• Suraja Menon Roychowdhury, PHD, LICAC, MAOM

• Dentist in Lexington, MA
• Providers in Lexington, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.