Alexandra Penta, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN1859765 Issued in MA

Practice address

102 Shore Dr Ste 302
Worcester, MA 01605-3154

Phone

(508) 854-9994

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lahair & Gallagher Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Worcester, MA
  • NPI 1003043514
  NPD (past)

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1629641907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 CONGRESS ST APT 602",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102818",
            "telephone_number": "617-347-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SHORE DR STE 302",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053154",
            "telephone_number": "508-854-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTA",
        "first_name": "ALEXANDRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043482",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1859765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph William Penna, DO
• Rozanna A. Penney, CRNA
• Stephen J Penney, R.PH
• Matthew Warren Penniman, BA
• Frederik A Pennings, M.D., PHD
• Mara Harvey Pentlarge, LICSW
• Amanda Penza, LICSW
• Shala Ivett Penzo
• People First Afc
• April Pepin

• Pediatric Dentistry in Worcester, MA
• Providers in Worcester, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.