Individual provider Active NPI

Angela Bhan, DMD

  • Dentist
  • Peabody, MA
National Provider Identifier
1669604567
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855201 Issued in MA
Practice address
210 Andover St
Peabody, MA 01960-1647
Phone
(978) 532-5550
NPI assigned
Aug 12, 2009
Last updated
Aug 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1855201 MA Primary

Addresses

Primary practice location

210 Andover St
Peabody, MA 01960-1647

Mailing address

210 Andover Street
Peabody, MA 01960
Phone (978) 532-5550

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
I20160307000728 MA Order and Referring Only - DentistPractitioner - Dentist 6507162294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855201MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1669604567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ANDOVER STREET",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-532-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ANDOVER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601647",
            "telephone_number": "978-532-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAN",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.