Dimitri Samaratunga, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN1856608 Issued in MA

Practice address

130 Water St
Fitchburg, MA 01420-5478

Phone

(978) 342-8500

NPI assigned

Jun 19, 2014

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 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1790199438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205478",
            "telephone_number": "978-342-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WATER ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205478",
            "telephone_number": "978-342-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARATUNGA",
        "first_name": "DIMITRI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856608",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosilver Salcedo, LCSW
• Jonathan Sallila
• Lisa Salvi, MA; BS
• Nikita Salwan, DMD
• Rebecca Susan Samara, MA
• Cristina Sampaio de Moreno, LLD
• John Seaborn Sampson III, D.M.D.
• Fatima Sanchez-Almonte
• Carmen Ivette Sanchez, RN
• Uganda Sanchez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.