Atlantic Dental

Primary specialty

DentistTaxonomy code 122300000X

License

20020 Issued in MA

Legal business name

ATLANTIC DENTAL

Practice address

153 Lewis St
Lynn, MA 01902-4835

Phone

(781) 599-3553

Fax

(781) 599-5959

NPI assigned

Apr 1, 2008

Last updated

Apr 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ilya VassermanNPI 1790900892

Title

President

Phone

(781) 599-3553

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ilya Vasserman, DMD

  • Dentist
  • Lynn, MA
  • NPI 1790900892
  NPD (past) Authorized official

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1770755514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 LEWIS ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024835",
            "telephone_number": "781-599-3553",
            "fax_number": "781-599-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 LEWIS ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024835",
            "telephone_number": "781-599-3553",
            "fax_number": "781-599-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "VASSERMAN",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-599-3553",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201421",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Achiri Asongwed, MHC
• Aspire Developmental Services, Inc. (North Shore Infant Toddler Program)
• Anastasios Athanasopoulos, DMD
• Natallie Atkins
• Atlantic Coast Ophthalmology, P.C.
• Atlantic Home Health LLC
• Atlantic Rest Home NP, Inc. (Atlantic Rest Home)
• Atlantic Rest Home, Inc
• Alaa Atoui
• Jessica Mary Auld

• Dentist in Lynn, MA
• Providers in Lynn, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.