Active NPI
Ana Dordevic, DMD
- Dentist
- Gloucester, MA
National Provider Identifier
1750145801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN10000601
- Practice address
- 501 Gloucester Crossing Rd
Gloucester, MA 01930-2289 - Phone
- (978) 675-2399
- NPI assigned
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN10000601 | MA | Primary |
Addresses
Primary practice location
501 Gloucester Crossing Rd
Gloucester, MA 01930-2289
Mailing address
501 Gloucester Crossing Rd
Gloucester, MA 01930-2289
Phone (978) 675-2399
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN10000601 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1750145801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 GLOUCESTER CROSSING RD",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019302289",
"telephone_number": "978-675-2399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 GLOUCESTER CROSSING RD",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019302289",
"telephone_number": "978-675-2399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORDEVIC",
"first_name": "ANA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN10000601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.