Active NPI
Maisie Tolzmann
- General Practice Dentistry
- Beverly, MA
National Provider Identifier
1346820644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN1859769
- Practice address
- 50 West St
Beverly, MA 01915-2228 - Phone
- (978) 927-3515
- NPI assigned
- Apr 11, 2021
- Last updated
- Jul 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1859769 | MA | Primary |
Addresses
Primary practice location
50 West St
Beverly, MA 01915-2228
Mailing address
50 West St
Beverly, MA 01915-2228
Phone (978) 927-3515
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | info@thousandoaksdentistry.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210601002806 | OH | Order and Referring Only - Dentist | 4880093434 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1859769 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wisconsin Dental Health, LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690070400000",
"number": "1346820644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 WEST ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019152228",
"telephone_number": "978-927-3515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 WEST ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019152228",
"telephone_number": "978-927-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLZMANN",
"first_name": "MAISIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-11",
"last_updated": "2023-07-23",
"certification_date": "2023-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1859769",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "info@thousandoaksdentistry.com",
"affiliation": "N",
"address_1": "390 S Grand Ave Ste 110",
"city": "Sun Prairie",
"state": "WI",
"country_code": "US",
"postal_code": "535909294",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; 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.