Individual provider Active NPI

Galina Gitlin, DMD

  • General Practice Dentistry
  • Lexington, MA
National Provider Identifier
1417038498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20831 Issued in MA
Practice address
62 Massachusetts Avenue
Lexington, MA 02420
Phone
(781) 863-9826
Fax
(781) 863-9829
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20831 MA Primary

Addresses

Primary practice location

62 Massachusetts Avenue
Lexington, MA 02420

Mailing address

62 Massachusetts Avenue
Lexington, MA 02420
Phone (781) 863-9826

Other names 1

  • Galina Gitlin Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161021001319 MA Order and Referring Only - DentistPractitioner - Dentist 9830477017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20831MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417038498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MASSACHUSETTS AVENUE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02420",
            "telephone_number": "781-863-9826",
            "fax_number": "781-863-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MASSACHUSETTS AVENUE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02420",
            "telephone_number": "781-863-9826",
            "fax_number": "781-863-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITLIN",
        "first_name": "GALINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GALINA",
            "last_name": "GITLIN",
            "credential": "DMD PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.