Individual provider Active NPI

William A Moschella, DMD

  • General Practice Dentistry
  • Saugus, MA
National Provider Identifier
1790898120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14200 Issued in MA
Practice address
20 Main St
Saugus, MA 01906-2340
Phone
(781) 233-2450
Fax
(781) 231-1873
NPI assigned
Aug 17, 2006
Sex
Male
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 14200 MA Primary

Addresses

Primary practice location

20 Main St
Saugus, MA 01906-2340

Mailing address

20 Main St
Saugus, MA 01906-2340
Phone (781) 233-2450

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
I20150521001689 MA Order and Referring Only - DentistPractitioner - Dentist 3274853858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14200MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790898120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MAIN ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019062340",
            "telephone_number": "781-233-2450",
            "fax_number": "781-231-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MAIN ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019062340",
            "telephone_number": "781-233-2450",
            "fax_number": "781-231-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCHELLA",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saugus, MA

Sources for this page

Verify at the official NPI Registry.