Oleg Agranovich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20000 Issued in MA

Practice address

100 Everette Ave
Dental Health International Ste 5
Chelsea, MA 02150

Phone

(617) 884-4444

Fax

(617) 884-4448

NPI assigned

Jul 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750310983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 HUNNEWELL ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02494",
            "telephone_number": "781-449-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EVERETTE AVE",
            "address_2": "DENTAL HEALTH INTERNATIONAL STE 5",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "617-884-4444",
            "fax_number": "617-884-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRANOVICH",
        "first_name": "OLEG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200069",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Chelsea, MA
• Providers in Chelsea, 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 Jul 8, 2007; 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.