Shant Baran, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 21115 Issued in MA

Practice address

2 Jungle Rd
Leominster, MA 01453-5208

Phone

(978) 534-8300

NPI assigned

Apr 25, 2008

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 5, 2022 through May 5, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1740455153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST",
            "address_2": "SUITE 407",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-414-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JUNGLE RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535208",
            "telephone_number": "978-534-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "386 Elm St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014403926",
            "country_code": "US",
            "telephone_number": "978-534-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Newton St",
            "address_2": "Suite 407",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182308",
            "country_code": "US",
            "telephone_number": "617-414-7558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARAN",
        "first_name": "SHANT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN 21115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Robert Ballou, PHARMD
• James S. Balutis, D.M.D.
• Bamberger Consulting Group PC
• Mitchell H Bamberger, MD
• Anna Marie Bannister, LMHC
• James Paul Barassi, DC
• Kalyn R Barger, PA-C
• Justine Marie Barlow
• Marybeth Barrett
• McCall Barrick, PNP

• Oral and Maxillofacial Surgery (Dentist) in Leominster, MA
• Providers in Leominster, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.