Individual provider Active NPI

Anita S Dovidio, DMD

  • General Practice Dentistry
  • Billerica, MA
National Provider Identifier
1578646980
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16980 Issued in MA
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, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 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 Former name

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
I20150424001003 MA Order and Referring Only - DentistPractitioner - Dentist 7214256239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16980MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
KD Medicine & Wellness PLLC PastSince May 20, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.