Annie M Amsalem, DDS
Individual provider Active NPI Periodontics · Arlington, MA
NPI 1497775050 · NPPES record last updated Jun 18, 2021
Key facts
- NPI
- 1497775050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 14104 (MA)
- Practice address
- 22 Mill St Ste 104
Arlington, MA 02476-4738 - Phone
- (781) 648-0279
- Fax
- (781) 641-3143
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160108000463 | MA | Order and Referring Only - Dentist |
1355643289 |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14104 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates in Family Dentistry | Past |
Accepting new patients | |
| Newton Dentistry PC | Periodontics | Past |
Accepting new patients |
| Natick Family Dental PC | Periodontics | Past |
Accepting new patients |
| Arlington Dental Associates PC | Periodontics | Past | Accepting new patients |
| Reading Dental Associates PC | Periodontics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 14104 | MA | Yes |
Addresses
Primary practice location
22 Mill St Ste 104
Arlington, MA 02476-4738
Mailing address
22 Mill St Ste 104
Arlington, MA 02476-4738
Phone (781) 648-0279
Other practice location 1
73 Lexington St Ste 204
Auburndale, MA 02466-1384
Phone (617) 244-5020
Other practice location 2
14 W Central St
Natick, MA 01760-4514
Phone (508) 720-5000
Other practice location 3
161 Ash St Ste B
Reading, MA 01867-3115
Phone (781) 944-6761
Other providers in Arlington, MA
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- Manobaldo Marcos Amaral
- Samantha Nicole Amico
- Jonathan B Ammen
- Kate Anastasio
- Zoi Arotana Andalcio
- Carita Michelle Anderson
- Herbert Ang
- Angela Pang, LLC
All providers in Arlington, MA · Periodontics in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.