Maryam Mandsaurwala

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1855042 Issued in MA

Practice address

1201 Bridge St
Lowell, MA 01850-1293

Phone

(978) 455-7056

NPI assigned

Apr 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• North Star Dental PLLC

  • Dentist
  • Worcester, MA
  • NPI 1487502993
  NPD Authorized official
• Lowell Dentistry and Braces, PC

  • Dentist
  • Lowell, MA
  • NPI 1881308310
  NPD (past)

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1700029824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BRIDGE ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018501293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BRIDGE ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018501293",
            "telephone_number": "978-455-7056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDSAURWALA",
        "first_name": "MARYAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inessa Maloney
• Alexandra Beata Malvey
• Socheata Mam
• Kelli Mandeville
• Tasha Lynn Mandeville, PMHNP-BC
• Nigar Manjanova
• Patricia Mankeh Manjong
• Valerie Manning-Jones, RN
• Cynthia Lynn Manning, M.D.
• Lovetta Mansaray

• General Practice Dentistry in Lowell, MA
• Providers in Lowell, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.