Serge Orlov, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20135 Issued in MA

Practice address

21 Main St
Watertown, MA 02472

Phone

(617) 924-9993

Fax

(617) 924-6860

NPI assigned

Mar 27, 2007

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 1

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1316065253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MAIN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724403",
            "telephone_number": "617-924-9993",
            "fax_number": "617-924-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MAIN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-924-9993",
            "fax_number": "617-924-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORLOV",
        "first_name": "SERGE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202240",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Beth O'Leary
• Meghan Maureen O'Neill
• Isabelle Obert, PT, DPT
• Brandon C Onyechefule, CNP
• Optometric Providers Inc
• Ailie Lauren Orzak
• Angela Owens
• Laura Pabo
• Jessica Pacheco, MOT, OTR/L
• Noemi P Padilla, NP

• General Practice Dentistry in Watertown, MA
• Providers in Watertown, 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 Sep 22, 2011; 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.