Individual provider Active NPI

Svetlana Livshin, D.M.D.

  • General Practice Dentistry
  • Walpole, MA
National Provider Identifier
1780741082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20346 Issued in MA
Practice address
254 Main St
Walpole, MA 02081-4058
Phone
(508) 660-9722
Fax
(508) 660-9766
NPI assigned
Jan 3, 2007
Sex
Female
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 20346 MA Primary

Addresses

Primary practice location

254 Main St
Walpole, MA 02081-4058

Mailing address

254 Main St
Walpole, MA 02081-4058
Phone (508) 660-9722

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
I20150701000243 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587976709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20346MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780741082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 MAIN ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020814058",
            "telephone_number": "508-660-9722",
            "fax_number": "508-660-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 MAIN ST",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020814058",
            "telephone_number": "508-660-9722",
            "fax_number": "508-660-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVSHIN",
        "first_name": "SVETLANA",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.