Individual provider Active NPI

Lia Mittelman, D.M.D

  • Dentist
  • Lawrence, MA
National Provider Identifier
1285037515
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856748 Issued in MA
Practice address
488 Essex St
Lawrence, MA 01840-1242
Phone
(603) 886-0000
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 04232 NH
Dentist 122300000X DEN4427 ME
Dentist 122300000X DN1856748 MA Primary

Addresses

Primary practice location

488 Essex St
Lawrence, MA 01840-1242

Mailing address

488 Essex St
Lawrence, MA 01840-1242
Phone (978) 975-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20150807013724 ME Order and Referring Only - DentistPractitioner - Dentist 4587978382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856748MAMDDentist
04232NHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jose L Rivera-Zayas DMD PLLC PastSince Jul 24, 2022 Accepting new patients
DB Practice Management, Inc PastSince Jul 24, 2022 Accepting new patients

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": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285037515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401242",
            "telephone_number": "978-975-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 ESSEX ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401242",
            "telephone_number": "603-886-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTELMAN",
        "first_name": "LIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "04232",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "DEN4427",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.