Individual provider Active NPI

Natasha S Yegorov, DMD

  • Dentist
  • Burlington, MA
National Provider Identifier
1568740967
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855745 Issued in MA
Practice address
83 Cambridge St Ste 3a
Burlington, MA 01803-4181
Phone
(781) 265-4500
Fax
(781) 265-4246
NPI assigned
Aug 2, 2011
Last updated
Feb 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1855745 MA Primary

Addresses

Primary practice location

83 Cambridge St Ste 3a
Burlington, MA 01803-4181

Mailing address

83 Cambridge St Ste 3a
Burlington, MA 01803-4181
Phone (781) 265-4500

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
I20160427001079 MA Order and Referring Only - DentistPractitioner - Dentist 4880993765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855745MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Dental PC Current Accepting new patients

Locations

83 Cambridge St
Ste 3A
Burlington, MA 01803
Phone (781) 221-7171

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1568740967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 CAMBRIDGE ST STE 3A",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034181",
            "telephone_number": "781-265-4500",
            "fax_number": "781-265-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 CAMBRIDGE ST STE 3A",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034181",
            "telephone_number": "781-265-4500",
            "fax_number": "781-265-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEGOROV",
        "first_name": "NATASHA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.