Individual provider Active NPI

Paul Francis Dimattia, DDS

  • General Practice Dentistry
  • Lexington, MA
National Provider Identifier
1750500807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13097 Issued in MA
Practice address
76 Bedford St Ste 8
Lexington, MA 02420-4640
Phone
(781) 862-0665
Fax
(781) 861-6628
NPI assigned
Apr 25, 2007
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 13097 MA Primary

Addresses

Primary practice location

76 Bedford St Ste 8
Lexington, MA 02420-4640

Mailing address

76 Bedford St Ste 8
Lexington, MA 02420-4640
Phone (781) 862-0665

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160620001483 MA Order and Referring Only - DentistPractitioner - Dentist 4284925421

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13097MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Paul F. Dimattia DDS General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750500807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BEDFORD ST STE 8",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204640",
            "telephone_number": "781-862-0665",
            "fax_number": "781-861-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 BEDFORD ST STE 8",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204640",
            "telephone_number": "781-862-0665",
            "fax_number": "781-861-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATTIA",
        "first_name": "PAUL",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "13097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.