Andrey Mazo, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18643 Issued in MA

Practice address

76 Otis St
Westborough, MA 01581-3315

Phone

(508) 870-1911

Fax

(508) 870-0639

NPI assigned

Mar 22, 2007

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

Other identifiers 1

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

Medicare enrollment (NPD)

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.

• Andrey Mazo DMD PC

  • General Practice Dentistry
  • Worcester, MA
  • NPI 1316385214
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1447377882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 OTIS ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015813315",
            "telephone_number": "508-870-1911",
            "fax_number": "508-870-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 OTIS ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015813315",
            "telephone_number": "508-870-1911",
            "fax_number": "508-870-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZO",
        "first_name": "ANDREY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0277975",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily M Marsick, CAGS LMHC
• Jennifer Lynn Martin, MPT
• Mary Bania Behavioral Consultation, LLC
• Massachusetts Psychotherapy Associates
• Vanessa J. Masse, NP-C
• Mazolender Partnership
• Beverly Kaye Mazza, RN
• Wanda Theresa Mazzamurro, D.C.
• Amina Mazzara, LMHC
• John B McCahan, M.D.

• General Practice Dentistry in Westborough, MA
• Providers in Westborough, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.