Individual provider Active NPI

Steven R Lazar, D.M.D.

  • General Practice Dentistry
  • Waltham, MA
National Provider Identifier
1740277631
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12224 Issued in MA
Practice address
25 Lionel Ave
Suite a
Waltham, MA 02452-4864
Phone
(781) 899-1157
Fax
(781) 899-1531
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12224 MA Primary

Addresses

Primary practice location

25 Lionel Ave
Suite a
Waltham, MA 02452-4864

Mailing address

211 College Rd
Concord, MA 01742-1526
Phone (978) 369-2314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12224MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740277631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COLLEGE RD",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421526",
            "telephone_number": "978-369-2314",
            "fax_number": "781-899-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LIONEL AVE",
            "address_2": "SUITE A",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024524864",
            "telephone_number": "781-899-1157",
            "fax_number": "781-899-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "12224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.