Individual provider Active NPI

Daniel Robert Fitzgerald, DMD

  • General Practice Dentistry
  • Andover, MA
National Provider Identifier
1821629247
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN9500091 Issued in MA
Practice address
19 Barnard St
Andover, MA 01810-3601
Phone
(978) 475-5333
NPI assigned
Feb 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 DN9500091 MA Primary

Addresses

Primary practice location

19 Barnard St
Andover, MA 01810-3601

Mailing address

11 Greenwood Ter
Somerville, MA 02143-3518
Phone (860) 682-5704

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
DN9500091MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry by Design, P.C. General Practice CurrentSince Mar 12, 2024 Accepting new patients

Locations

19 Barnard St
Andover, MA 01810
Phone (978) 475-5333

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1821629247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GREENWOOD TER",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433518",
            "telephone_number": "860-682-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BARNARD ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103601",
            "telephone_number": "978-475-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN9500091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.