Vatche Seraderian, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

17470 Issued in MA

Practice address

84 Leonard St
Belmont, MA 02478-2519

Phone

(617) 489-1215

Fax

(617) 489-8736

NPI assigned

Apr 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

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

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831319367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 LEONARD ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782519",
            "telephone_number": "617-489-1215",
            "fax_number": "617-489-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 LEONARD ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782519",
            "telephone_number": "617-489-1215",
            "fax_number": "617-489-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERADERIAN",
        "first_name": "VATCHE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "17470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas R Sciascia, M.D.
• Paer R Scott, LIC. AC.
• Stephen Jay Seiner, M.D.
• Antonia Victoria Seligowski, PHD
• Clare Sellig, PMHCNS-BC
• Avraham Y Shainhouse, DDS
• Patrick Shanley, LCSW
• Leslie Shapiro, LICSW
• Chloe Gabrielle Sharp, MD
• Shaws Supermarkets Inc (Shaws Pharmacy #2583)

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

• 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.
• 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.