Individual provider Active NPI

Jyoti Mahajan, DMD

  • Dentist
  • Lynn, MA
National Provider Identifier
1770700692
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21137 Issued in MA
Practice address
160 Market St
Lynn, MA 01901-1529
Phone
(781) 593-1133
NPI assigned
Apr 20, 2007
Last updated
Oct 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21137 MA Primary

Addresses

Primary practice location

160 Market St
Lynn, MA 01901-1529

Mailing address

160 Market St
Lynn, MA 01901-1529
Phone (781) 593-1133

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
I20161118002242 MA Order and Referring Only - DentistPractitioner - Dentist 6901185727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21137MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alegre Dental Center Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1770700692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011529",
            "telephone_number": "781-593-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MARKET ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011529",
            "telephone_number": "781-593-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "JYOTI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.