Individual provider Active NPI

Danielle Lacoste Kilmartin, DMD

  • Endodontics
  • New Bedford, MA
National Provider Identifier
1629163290
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
19934 Issued in MA
Practice address
1155 Purchase Street
New Bedford, MA 02740
Phone
(508) 997-1766
Fax
(508) 996-4558
NPI assigned
Oct 3, 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
Endodontics 1223E0200X 19934 MA Primary

Addresses

Primary practice location

1155 Purchase Street
New Bedford, MA 02740

Mailing address

1155 Purchase Street
New Bedford, MA 02740
Phone (508) 997-1766

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
I20150708000542 MA Order and Referring Only - DentistPractitioner - Dentist 1850603622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19934MAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629163290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 PURCHASE STREET",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740",
            "telephone_number": "508-997-1766",
            "fax_number": "508-996-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 PURCHASE STREET",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740",
            "telephone_number": "508-997-1766",
            "fax_number": "508-996-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILMARTIN",
        "first_name": "DANIELLE",
        "middle_name": "LACOSTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "19934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.