Individual provider Active NPI

Despina Liakos, DMD

  • General Practice Dentistry
  • Norwood, MA
National Provider Identifier
1528183688
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20392 Issued in MA
Practice address
761 Washington St
Norwood, MA 02062-6612
Phone
(781) 762-7900
NPI assigned
Mar 20, 2007
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20392 MA Primary

Addresses

Primary practice location

761 Washington St
Norwood, MA 02062-6612

Mailing address

761 Washington St
Norwood, MA 02062-6612
Phone (781) 762-7900

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721001816 MA Order and Referring Only - DentistPractitioner - Dentist 5698088557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20392MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric and Family Dentistry of Norwood PLLC General Practice Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1528183688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020626612",
            "telephone_number": "781-762-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020626612",
            "telephone_number": "781-762-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAKOS",
        "first_name": "DESPINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.