NPIMap

Organization Active NPI

Nanette Demonteverde, DMD, PC

  • General Practice Dentistry
  • Medford, MA
National Provider Identifier
1346463973
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16915 Issued in MA
Legal business name
NANETTE DEMONTEVERDE, DMD, PC
Practice address
30 Main St
Medford, MA 02155-7112
Phone
(781) 391-2440
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nanette Canero Demonteverde, DMDNPI 1609982370
Title
President
Phone
(781) 391-2440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16915 MA Primary

Addresses

Primary practice location

30 Main St
Medford, MA 02155-7112

Mailing address

30 Main St
Medford, MA 02155-7112
Phone (781) 391-2440

Other identifiers 1

IdentifierTypeStateIssuer
9708791MedicaidMA

National Provider Directory

National Provider Directory

Locations

30 Main St
Medford, MA 02155
Phone (781) 391-2440

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346463973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021557112",
            "telephone_number": "781-391-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021557112",
            "telephone_number": "781-391-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANETTE DEMONTEVERDE, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMONTEVERDE",
        "authorized_official_first_name": "NANETTE",
        "authorized_official_middle_name": "CANERO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-391-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9708791",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.