Shiferaw Awlachew Sr., ETC

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

DA08481 Issued in MA

Practice address

14 Pleasant St
Everett, MA 02149-2811

Phone

(781) 300-1774

NPI assigned

Feb 15, 2020

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1386277663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PLEASANT ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492811",
            "telephone_number": "781-300-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PLEASANT ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492811",
            "telephone_number": "781-300-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWLACHEW",
        "first_name": "SHIFERAW",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "ETC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Assistant",
            "state": "MA",
            "license": "DA08481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451734099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Anand, DMD
• Pedro Angeles, RPH
• Areeva Dental LLC
• Girma Asfaw
• Mehrnoosh Ashabi, O.D
• Aishatu Baba
• Nona Balian
• Nancy Lima Banfield, MSPT
• Michelle Anne Barnstein-Grossman, M.A., CCC-SLP
• Barone and Cognata DMD PC

• Dental Assistant in Everett, MA
• Providers in Everett, MA by specialty
• Dental Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.