Andrew George Vultaggio, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN1000412 Issued in MA

Practice address

115 Thoreau St
Concord, MA 01742-2443

Phone

(978) 371-2792

NPI assigned

Aug 9, 2024

Sex

Male

Sole proprietor

No

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.

• Stephen M. Vultaggio DDS, PC

  • Dental Clinic/Center
  • Concord, MA
  • NPI 1477070571
  NPD (past)

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1437980778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 THOREAU ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422443",
            "telephone_number": "978-371-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 THOREAU ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422443",
            "telephone_number": "978-371-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VULTAGGIO",
        "first_name": "ANDREW",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1000412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Vincent, PH.D.
• Brenda Viola, P.T.
• Daniel H Vogel, M.D.
• Volunteers of America-Concord Park
• Lynne Volz, MA
• Stephen Mario Vultaggio, D.D.S.
• Stuart Wachter, M.D.
• Sara Wagg, LMHC
• Maria E Walazek, RD, LDN
• Walden Pond Pediatrics, PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.