Robert Lindsay Mandell, D.M. D. , M.M.SC.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

13306 Issued in MA

Practice address

164 Westford Rd
Suite 8
Tyngsboro, MA 01879-2530

Phone

(978) 649-3058

Fax

(978) 649-9566

NPI assigned

Jan 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548327604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 LOWELL ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018671533",
            "telephone_number": "781-942-0190",
            "fax_number": "781-944-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WESTFORD RD",
            "address_2": "SUITE 8",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018792530",
            "telephone_number": "978-649-3058",
            "fax_number": "978-649-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDELL",
        "first_name": "ROBERT",
        "middle_name": "LINDSAY",
        "name_prefix": "Dr.",
        "credential": "D.M. D. , M.M.SC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "13306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Tyngsboro, MA
• Providers in Tyngsboro, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.