Individual provider Active NPI

Seymour H Andrus, D.M.D.

  • General Practice Dentistry
  • Cambridge, MA
National Provider Identifier
1801952841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10416 Issued in MA
Practice address
872 Massachusetts Ave
Suite 2-6
Cambridge, MA 02139-3073
Phone
(617) 491-0943
Fax
(617) 491-6267
NPI assigned
Dec 27, 2006
Sex
Male
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 10416 MA Primary

Addresses

Primary practice location

872 Massachusetts Ave
Suite 2-6
Cambridge, MA 02139-3073

Mailing address

872 Massachusetts Ave
Suite 2-6
Cambridge, MA 02139-3073
Phone (617) 491-0943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10416MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801952841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MASSACHUSETTS AVE",
            "address_2": "SUITE 2-6",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393073",
            "telephone_number": "617-491-0943",
            "fax_number": "617-491-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 MASSACHUSETTS AVE",
            "address_2": "SUITE 2-6",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393073",
            "telephone_number": "617-491-0943",
            "fax_number": "617-491-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "SEYMOUR",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "10416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.