Gladys G. Carrasco Roman

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

016.0133993 Issued in VT

Practice address

180 Walnut Street
Chelsea, MA 02150

Phone

(617) 889-2864

NPI assigned

Feb 21, 2018

Last updated

Feb 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1518468099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 INWOOD DR APT 1005",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018015279",
            "telephone_number": "617-270-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WALNUT STREET",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "617-889-2864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Union St",
            "address_purpose": "LOCATION",
            "city": "Orleans",
            "state": "VT",
            "postal_code": "058601218",
            "country_code": "US",
            "telephone_number": "617-270-1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASCO ROMAN",
        "first_name": "GLADYS",
        "middle_name": "G.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DF11267",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VT",
            "license": "016.0133993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolas Paul Carlino
• Meridith Louise Carlson, LCSW
• Michele Carmi
• Samantha Caron, LPN
• Lisa Sibert Carr, MD
• Santiago Alfonso Carvallo, MSW
• Sadie Casseus
• Alejandra Castro, MSW
• Shirley Castro
• Michelle Cataldo

• Pediatric Dentistry in Chelsea, MA
• Providers in Chelsea, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.