Individual provider Active NPI

Marmar Mesgarzadeh, DMD

  • General Practice Dentistry
  • Brookline, MA
National Provider Identifier
1871689752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21215 Issued in MA
Practice address
1037A Beacon St
Brookline, MA 02446-5609
Phone
(617) 232-1515
NPI assigned
Oct 5, 2006
Sex
Female
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 21215 MA Primary

Addresses

Primary practice location

1037A Beacon St
Brookline, MA 02446-5609

Mailing address

1037A Beacon St
Brookline, MA 02446-5609
Phone (617) 232-1515

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
I20150720001281 MA Order and Referring Only - DentistPractitioner - Dentist 1456664598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21215MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
42 North Dental Care, LLC Past Accepting new patients

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871689752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037A BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465609",
            "telephone_number": "617-232-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037A BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465609",
            "telephone_number": "617-232-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESGARZADEH",
        "first_name": "MARMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.