Lawrence William Bandoni, DMD
Individual provider Active NPI General Practice Dentistry · Hanover, MA
NPI 1679627780 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679627780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 15059 (MA)
- Practice address
- 51 Mill St
Suite # 6
Hanover, MA 02339 - Phone
- (781) 829-4568
- Fax
- (781) 829-9124
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170109000514 | MA | Order and Referring Only - Other (Physician) |
1658652516 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15059 | MA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15059 | MA | Yes |
Addresses
Primary practice location
51 Mill St
Suite # 6
Hanover, MA 02339
Mailing address
51 Mill St
Suite # 6
Hanover, MA 02339
Phone (781) 829-4568
Other providers in Hanover, MA
- Susan J Avedissian
- Samantha Lee Babineau
- Victoria Leigh Baczek
- Maureen Baker
- Angelo John Balsamo
- Kristen L. Barletta
- Amy H Baron
- Nicole Bassey
- Bella Natural Health Inc.
- Amy J Bennett
All providers in Hanover, MA · General Practice Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.