Active NPI
Anne Lukretia Wucherpfennig, DMD
- Endodontics
- Brookline, MA
National Provider Identifier
1457469520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 20554
- Practice address
- 1199 Beacon St
Lower Level
Brookline, MA 02446-5352 - Phone
- (617) 734-8599
- NPI assigned
- Aug 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 20554 | MA | Primary |
| Endodontics | 1223E0200X | 2901018075 | MI |
Addresses
Primary practice location
1199 Beacon St
Lower Level
Brookline, MA 02446-5352
Mailing address
67 Highland Rd
Brookline, MA 02445-7052
Phone (617) 277-1322
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150331001748 | MA | Order and Referring Only - Other (Non-Physician) | 3375860398 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20554 | MA | MD | Endodontist |
| 2901018075 | MI | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424908800000",
"number": "1457469520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 HIGHLAND RD",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024457052",
"telephone_number": "617-277-1322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 BEACON ST",
"address_2": "LOWER LEVEL",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465352",
"telephone_number": "617-734-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUCHERPFENNIG",
"first_name": "ANNE",
"middle_name": "LUKRETIA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2015-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "20554",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "2901018075",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.