Individual provider Active NPI

Zully Teresa Criado-Hedreen, D.D.S.

  • General Practice Dentistry
  • Cambridge, MA
National Provider Identifier
1700024361
Registry record updated Feb 4, 2009
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18541 Issued in MA
Practice address
825 Cambridge St
Cambridge, MA 02141-1429
Phone
(617) 492-7626
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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 18541 MA Primary

Addresses

Primary practice location

825 Cambridge St
Cambridge, MA 02141-1429

Mailing address

825 Cambridge St
Cambridge, MA 02141-1429
Phone (617) 492-7626

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
I20141117001143 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5193947620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18541MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1700024361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411429",
            "telephone_number": "617-492-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411429",
            "telephone_number": "617-492-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIADO-HEDREEN",
        "first_name": "ZULLY",
        "middle_name": "TERESA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.