Dmitry Grigory Merzon, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

DN1856532 Issued in MA

Practice address

1751 Massachusetts Ave FL 1
Cambridge, MA 02140-2218

Phone

(617) 855-9092

NPI assigned

May 23, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• First Impression Dental, PLLC

  • Dental Clinic/Center
  • Cambridge, MA
  • NPI 1124484001
  NPD (past) Authorized official

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1437561560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 MASSACHUSETTS AVE FL 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402218",
            "telephone_number": "617-207-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 MASSACHUSETTS AVE FL 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402218",
            "telephone_number": "617-855-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERZON",
        "first_name": "DMITRY",
        "middle_name": "GRIGORY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Merlo, M.S., BCBA, LABA
• Erin Merritt
• Kelsey Merritt
• Krystal Mershon, FNP-BC
• Irene Merwin, PSY.D.
• Kerrin Meseck, MS, RD, LDN
• Uriel Meshoulam, PH.D.
• Tamara Mesquita Assuncao
• Danielle Messimer, RN
• Phillip Messineo, DC

• Dentist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.