Individual provider Active NPI

Lisa B Emirzian, DMD

  • General Practice Dentistry
  • E Longmeadow, MA
National Provider Identifier
1780742486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15280 Issued in MA
Practice address
16 Gerrard Avenue
E Longmeadow, MA 01028-1606
Phone
(413) 732-6281
Fax
(413) 731-8815
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 15280 MA Primary

Addresses

Primary practice location

16 Gerrard Avenue
E Longmeadow, MA 01028-1606

Mailing address

16 Gerrard Avenue
E Longmeadow, MA 01028-1606
Phone (413) 732-6281

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
I20160502000431 MA Order and Referring Only - DentistPractitioner - Dentist 2567761232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15280MAMDAddiction (Substance Use Disorder) Counselor

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780742486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GERRARD AVENUE",
            "city": "E LONGMEADOW",
            "state": "MA",
            "postal_code": "010281606",
            "telephone_number": "413-732-6281",
            "fax_number": "413-731-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 GERRARD AVENUE",
            "city": "E LONGMEADOW",
            "state": "MA",
            "postal_code": "010281606",
            "telephone_number": "413-732-6281",
            "fax_number": "413-731-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMIRZIAN",
        "first_name": "LISA",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in E Longmeadow, MA

Sources for this page

Verify at the official NPI Registry.