Desh Deep Mandhyan, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010347 Issued in CT

Practice address

175 Union St
Lynn, MA 01901-1310

Phone

(781) 592-9250

NPI assigned

Jul 23, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1760612857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WORCESTER ST",
            "address_2": "APT 101",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183322",
            "telephone_number": "405-219-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011310",
            "telephone_number": "781-592-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDHYAN",
        "first_name": "DESH DEEP",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855224",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Anne Malloch, DNP, PMHNP
• Ashley Mallon, PMHNP-BC
• Pamela Fineman Maltz, MSW
• Vibol Mam, RPH
• Maria C Mancini, RN
• Jennifer Manigat
• Anna Marie Manzano, RN
• Brittny Maravelias
• Jenny Marcelin
• Angel Jose Marcelino

• General Practice Dentistry in Lynn, MA
• Providers in Lynn, 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 Aug 27, 2013; 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.