Active NPI
Anita S Dovidio, DMD
- General Practice Dentistry
- Billerica, MA
National Provider Identifier
1578646980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16980
- Practice address
- 337 Boston Rd
Billerica, MA 01821 - Phone
- (978) 663-3321
- Fax
- (978) 667-6361
- NPI assigned
- Oct 23, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16980 | MA | Primary |
Addresses
Primary practice location
337 Boston Rd
Billerica, MA 01821
Mailing address
337 Boston Rd
Billerica, MA 01821
Phone (978) 663-3321
Other names 1
- Anita Braverman
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150424001003 | MA | Order and Referring Only - Dentist | 7214256239 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16980 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KD Medicine & Wellness PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/24138/brand/1/csg/1/fhir/r4
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.
-
dba KD Medicine & Wellness
- Physician Assistant
- North Andover, MA
- NPI 1669049995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578646980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 BOSTON RD",
"city": "BILLERICA",
"state": "MA",
"postal_code": "01821",
"telephone_number": "978-663-3321",
"fax_number": "978-667-6361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 BOSTON RD",
"city": "BILLERICA",
"state": "MA",
"postal_code": "01821",
"telephone_number": "978-663-3321",
"fax_number": "978-667-6361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOVIDIO",
"first_name": "ANITA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "16980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANITA",
"last_name": "BRAVERMAN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Billerica, MA
Sources for this page
- 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.